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160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure
BACKGROUND: Animal-assisted interventions (AAI), the use of animals as a complementary therapy in holistic patient care, has shown many positive outcomes. However, therapy animals can serve as mechanical vectors of hospital-associated infections (HAI), e.g., methicillin-resistant Staphylococcus aure...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253034/ http://dx.doi.org/10.1093/ofid/ofy209.030 |
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author | Dalton, Kathryn Ruble, Kathy DeLone, Alexandra Frankenfield, Pam Walker, Destiny Ludwig, Shanna Ross, Tracy L Jaskulski, Janice Carroll, Karen C Rankin, Shelley Morris, Daniel Chen, Allen Davis, Meghan |
author_facet | Dalton, Kathryn Ruble, Kathy DeLone, Alexandra Frankenfield, Pam Walker, Destiny Ludwig, Shanna Ross, Tracy L Jaskulski, Janice Carroll, Karen C Rankin, Shelley Morris, Daniel Chen, Allen Davis, Meghan |
author_sort | Dalton, Kathryn |
collection | PubMed |
description | BACKGROUND: Animal-assisted interventions (AAI), the use of animals as a complementary therapy in holistic patient care, has shown many positive outcomes. However, therapy animals can serve as mechanical vectors of hospital-associated infections (HAI), e.g., methicillin-resistant Staphylococcus aureus (MRSA). This pilot study assessed for transmission of HAIs among therapy animals, patients, and the hospital environment. We tested the effectiveness of a novel decolonization protocol for therapy dogs to reduce the risk of transmission of HAIs and enhance AAI program sustainability. Our hypothesis was that HAI transmission occurs from positive child to child, with the dog as an intermediary fomite. METHODS: Before and after child–animal interaction, we sampled patients, dogs, and the environment, and collected vital statistics and survey data from patients. MRSA was detected in samples by culture and molecular testing. Therapy dog handlers performed normal pre-visit practices for 2 control visits, then switched to a decolonization protocol (chlorhexidine-based shampoo prior to the visit, and chlorhexidine wipes on the fur during the visit) for 2 intervention visits. RESULTS: We evaluated 45 children and 4 therapy dogs over 13 visits. Children had decreased blood pressure and heart rate, and reported improved mental health scores post visit. MRSA conversion was identified from 10.2% of the children and 38.5% of the dogs, while 93% of the environmental samples were MRSA positive both pre and post. Patients that interacted closely with the dog had 8.01 times higher odds (95% CI 1.1–15.2) of MRSA conversion compared with patients who barely interacted with the dog. When stratified by intervention group, the MRSA conversation odds ratio of close interaction was 0.93 (95% CI 0.1–10.8) when the dog was decolonized versus 9.72 (0.9–99) when not decolonized. CONCLUSION: This study showed the potential for AAI visits to improve physiological and mental health of pediatric outpatients. A risk of HAI exposure to patients from interaction with the dog was found, but this effect was nullified by the decolonization procedure. Future research is needed to increase the safety of this valuable alternative therapy. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6253034 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62530342018-11-28 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure Dalton, Kathryn Ruble, Kathy DeLone, Alexandra Frankenfield, Pam Walker, Destiny Ludwig, Shanna Ross, Tracy L Jaskulski, Janice Carroll, Karen C Rankin, Shelley Morris, Daniel Chen, Allen Davis, Meghan Open Forum Infect Dis Abstracts BACKGROUND: Animal-assisted interventions (AAI), the use of animals as a complementary therapy in holistic patient care, has shown many positive outcomes. However, therapy animals can serve as mechanical vectors of hospital-associated infections (HAI), e.g., methicillin-resistant Staphylococcus aureus (MRSA). This pilot study assessed for transmission of HAIs among therapy animals, patients, and the hospital environment. We tested the effectiveness of a novel decolonization protocol for therapy dogs to reduce the risk of transmission of HAIs and enhance AAI program sustainability. Our hypothesis was that HAI transmission occurs from positive child to child, with the dog as an intermediary fomite. METHODS: Before and after child–animal interaction, we sampled patients, dogs, and the environment, and collected vital statistics and survey data from patients. MRSA was detected in samples by culture and molecular testing. Therapy dog handlers performed normal pre-visit practices for 2 control visits, then switched to a decolonization protocol (chlorhexidine-based shampoo prior to the visit, and chlorhexidine wipes on the fur during the visit) for 2 intervention visits. RESULTS: We evaluated 45 children and 4 therapy dogs over 13 visits. Children had decreased blood pressure and heart rate, and reported improved mental health scores post visit. MRSA conversion was identified from 10.2% of the children and 38.5% of the dogs, while 93% of the environmental samples were MRSA positive both pre and post. Patients that interacted closely with the dog had 8.01 times higher odds (95% CI 1.1–15.2) of MRSA conversion compared with patients who barely interacted with the dog. When stratified by intervention group, the MRSA conversation odds ratio of close interaction was 0.93 (95% CI 0.1–10.8) when the dog was decolonized versus 9.72 (0.9–99) when not decolonized. CONCLUSION: This study showed the potential for AAI visits to improve physiological and mental health of pediatric outpatients. A risk of HAI exposure to patients from interaction with the dog was found, but this effect was nullified by the decolonization procedure. Future research is needed to increase the safety of this valuable alternative therapy. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253034/ http://dx.doi.org/10.1093/ofid/ofy209.030 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Dalton, Kathryn Ruble, Kathy DeLone, Alexandra Frankenfield, Pam Walker, Destiny Ludwig, Shanna Ross, Tracy L Jaskulski, Janice Carroll, Karen C Rankin, Shelley Morris, Daniel Chen, Allen Davis, Meghan 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title | 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title_full | 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title_fullStr | 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title_full_unstemmed | 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title_short | 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure |
title_sort | 160. reduction in the spread of hospital-associated infections among pediatric oncology patients in an animal-assisted intervention program from a canine decolonization procedure |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253034/ http://dx.doi.org/10.1093/ofid/ofy209.030 |
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