Can gowns and gloves help save $4 billion a year? The "BUGG" Study aims to find out.

University Hospital’s Medical Cardiac Care Unit (MCCU) joins ICU infection study

Beginning today, and for the next nine months, every person walking into any patient room in the Medical Cardiac Care Unit (MCCU) at University Hospital will be wearing a protective gown and gloves. Currently the recognized standard of care is to only use gowns and gloves when entering the rooms of patients placed in contact isolation due to existing resistant bacteria. The new protocols are part of an important national study to determine how hospitals can best decrease antibiotic-resistant bacteria and health care-associated infections.

Healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths annually. Antibiotic resistance is associated with considerable morbidity, mortality and costs among hospitalized patients. It is estimated that the cost of antibiotic resistance in the United States is greater than $4 billion per year.

The MCCU at University Hospital is one of just 20 intensive care units nationwide chosen to participate in this research initiative to compare current protocols with gowns and gloves for all patients. It’s called the Benefits of Universal Gown and Gloving (BUGG) Study and it is only the third multicenter, randomized trial in infection control. The Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention (CDC), The Joint Commission, and a research team including Yale and the University of Maryland lead the study nationwide. MCCU Medical Director Dr. Stephanie Levine and Hospital Epidemiologist Dr. Jason Bowling lead the study at University Hospital. Drs. Levine and Bowling are with UT Medicine San Antonio, the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio. Dr. Levine is a professor of Pulmonary Disease and Dr. Bowling is an assistant professor of Infectious Diseases.

The MCCU began a baseline collection in August. During this time, nursing staff began obtaining cultures for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) for all patients admitted to the unit. Cultures are taken a second time, as patients are being discharged. Starting January 4, 2012, the MCCU will begin using universal gloves and gowning (for all patients) for nine months.

The intensive care unit (ICU) is the highest risk environment for healthcare-associated infections and acquisition of antibiotic-resistant bacteria. The intervention is simple and potentially works against all infections and prevents the transmission of all antibiotic-resistant bacteria.

Dr. Carolyn Clancy, the Director of the Agency for Healthcare Research and Quality (AHRQ) has high expectations for the study: “We expect that the findings of this study will result in improvements in the American health care system.” Doctors and nurses in MCCU at University Hospital are thrilled to be participating in this important study. “Everyone is trying to find ways to reduce these infections but there is limited available data,” said University Hospital Epidemiologist Dr. Jason Bowling. “The findings will likely impact existing guidelines on Infection Control given the number of sites participating and the robust study design.” Other study sites include Johns Hopkins, Emory and Henry Ford Health System.

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