Patient Privacy Curtains an Overlooked Carrier of MDR Pathogens

MDROs were detected in 334 (22%) curtain cultures from 6 skilled nursing facilities in southeast Michigan.

Of all the hospital fomites, patient privacy curtains might be the most often overlooked. These high-touch surfaces are cleaned infrequently and could contribute to pathogen transmission.

Investigators with University of Michigan Medical Center & University Hospital in Ann Arbor set out to evaluate the level of contamination of these privacy curtains in 6 skilled nursing facilities in southeast Michigan. Specifically, the prospective cohort study sought to determine whether the curtains harbor multidrug-resistant organisms (MDRO).

The findings are to be presented in a poster session at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2019).

With consent, the team collected cultures from several patient body sites and high-touch surfaces in the room, including the curtains (near the edges where they were most frequently touched), upon admission, at day 14, day 30, and monthly up to 6 months. A total of 1521 curtain samples were collected from 625 short-stay patient rooms.

“We were particularly interested in concordance between patient colonization and curtain contamination with an MDRO at the same visit and whether this contamination was intermittent or persistent among those with 6 months of follow-up,” investigators reported.

After analyzing the data, the research team saw that privacy curtain contamination in patient rooms was common, and that curtains were most often contaminated with the same MDRO as the patient in that room.

MDROs were detected in 334 (22%) curtain cultures (facility range 11.9%-28.5%). Vancomycin-resistant enterococci (VRE) was the most common pathogen with 210 (13.8%) positive cultures. There were 94 (6.2%) curtain cultures positive for resistant gram-negative bacilli (R-GNB) and 74 (4.9%) positive for methicillin-resistant Staphylococcus aureus (MRSA). There was no difference detected between the contamination levels in private rooms (6/26 [23.1%]) vs shared rooms (328/1492 [22.0%]).

In 15.7% (238/1518) of check-ins, patients and their privacy curtains were concurrently colonized with the same MDRO. Patient colonization with MRSA and VRE were each associated with contamination of the bedside curtain, investigators determined. Curtain contamination was often intermittent among 18 patients with 6 months of follow up.

“We were surprised to see that MDROs, especially VRE, shed by patients routinely contaminate their privacy curtains. These pathogens on privacy curtains often survive and have the potential to transfer to other surfaces and patients,” investigators concluded. “As privacy curtains are used all over the world, it’s a global issue. Further studies are needed to determine conclusively whether contaminated privacy curtains are a source of MDRO transmission to patients.”

The study, “Privacy Curtain Contamination in Six Post-Acute Care Facilities in Michigan,” will be presented in a poster session on Tuesday, April 16, 2019, at ECCMID 2019 in Amsterdam, the Netherlands.