160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure.
Session: Oral Abstract Session: Healthcare Epidemiology: Special Populations
Thursday, October 4, 2018: 10:45 AM
Room: S 156
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 two 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 two 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% confidence interval (CI): 1.1 – 15.2] of MRSA conversion compared to 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.

Kathryn Dalton, VMD, MPH1, Kathy Ruble, RN, CPNP, PhD2, Alexandra DeLone, MA, MS, CCLS2, Pam Frankenfield, RN2, Destiny Walker, BS2, Shanna Ludwig, PhD3, Tracy L. Ross, MT(ASCP)4, Janice Jaskulski, MS, OTR/L5, Karen C. Carroll, MD, FIDSA6, Shelley Rankin, PhD7, Daniel Morris, DVM, MPH, DACVD7, Allen Chen, MD, PhD, MHS2 and Meghan Davis, PhD DVM MPH8, (1)Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (2)Johns Hopkin Medicine Pediatric Oncology Outpatient Clinic, Baltimore, MD, (3)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (4)Johns Hopkins Medical Institutions, Baltimore, MD, (5)Johns Hopkin Medicine, Baltimore, MD, (6)Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD, (7)University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, (8)Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Disclosures:

K. Dalton, None

K. Ruble, None

A. DeLone, None

P. Frankenfield, None

D. Walker, None

S. Ludwig, None

T. L. Ross, None

J. Jaskulski, None

K. C. Carroll, None

S. Rankin, None

D. Morris, None

A. Chen, None

M. Davis, None

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