The curtains that hang between patient beds in hospitals can become contaminated with drug-resistant bacteria and may be playing a role in the spread of these germs in hospitals, a new study suggests.
Researchers at Cleveland Veterans Affairs Medical Center in Cleveland, Ohio, showed that C. difficile, methicillin-resistant Staphylococcus aureus — also known as MRSA — and vancomycin-resistant enterococci or VRE can be found on hospital privacy curtains.
'Changing bed linen, that's easy. Changing privacy curtains, on the other hand, is a pain in the neck.' — Dr. Allison McGeer
Even more importantly, they found that the bugs transfer onto the hands of people who handle the contaminated curtains — suggesting that health-care workers who pull curtains closed and then touch patients may be spreading bacteria.
"I think that the demonstration that you can acquire them on hands … relatively easily would suggest that curtains would have the potential to contribute to transmission," said Dr. Curtis Donskey, director of infection control with the hospital and the senior author on the study.
The findings will be published in the November issue of the journal Infection Control and Hospital Epidemiology and were presented Tuesday at a joint scientific conference of the American Society for Microbiology and the Infectious Diseases Society of America in Washington, D.C.
Donskey and his colleagues wanted to see if privacy curtains are a potential source of contamination with these germs, so they tested curtains actually hanging in their facility. Their hospital, like many others, washes privacy curtains every four months or if they are visibly soiled.
In addition to culturing the curtains to see what bugs they might be harbouring, the researchers had volunteers wearing surgical gloves touch the curtains in areas where the fabric is generally grabbed by people handling the curtains, then press their hands onto plates containing growth media to see if they'd picked up germs on their hands.
They found 42 per cent of privacy curtains were contaminated with VRE, which can cause wound, urinary tract and other infections and 22 per cent with MRSA, which can cause bloodstream infections, pneumonia and surgical site infections. Four per cent of the curtains tested were positive for Clostridium difficile spores.
Curtains changed after discharge in Canada
When testing was done to see if handling the curtains transferred germs to the hands, the results showed small numbers of all three pathogens were found on hands after handling the drapes.
"We were a little bit surprised but not too surprised. Because we know that these things are not being cleaned (often) and we know that these organisms can survive" in the environment, Donskey said.
The highest rates of positive results were found in rooms where patients known to be carrying one of these bugs were in isolation.
In Canada, those curtains would come down after the isolated patient was discharged, said Dr. Andrew Simor, head of microbiology at Toronto's Sunnybrook Health Sciences Centre.
Donskey said that is not the policy in his hospital and he believes many other facilities don't routinely clean curtains between patients treated in isolation. "One of the reasons we did the study was to ask: Should we be doing something more to make sure these things are clean?"
Experts said the findings suggest more care should be taken with hospital curtains. But finding an answer may be difficult, said Dr. Allison McGeer, head of infection control at Toronto's Mount Sinai Hospital.
"The issue is that privacy curtains are, relative to other linen we use in the hospital, relatively expensive, more difficult to clean, and of course it takes much more time with the systems we use to hang them," she said.
"You've got to stand up on a ladder and then you've got to hook all these teeny, tiny hooks in."
"Changing bed linen, that's easy. Changing privacy curtains, on the other hand, is a pain in the neck."
Donskey and his co-authors raised the possibility of detachable handles that could be used to pull the curtains and which could be laundered more easily. As well, he said, it may be possible to spray hanging curtains with cleaners that would kill the bacteria.
In the meantime, he said, it's important for health-care workers to realize that curtains can be a source of contamination and that they should wash their hands after touching them.