New research has found that patients who spent more time with therapy dogs increased their risk of contracting the superbug MRSA—a warning to hospitals that haven't examined their policies surrounding the popular programs.
Researchers from Johns Hopkins Bloomberg School of Public Health recently unveiled the unpublished limited study. Co-author Dr. Meghan Davis, a veterinarian and assistant professor of environmental health and engineering at Johns Hopkins, was looking at the potential for human-to-human transmission of pathogens during dog therapy support visits.
The interventional study observed 45 children at Johns Hopkins' pediatric oncology outpatient wards who had dog visits in 2016 and 2017. None of those children tested positive for MRSA before their interactions with the dogs. After the visits, researchers found MRSA on 10% of the samples taken from the children and on nearly 40% of samples taken from the dogs.
MRSA can live on the skin without causing symptoms. But the bacteria can become more dangerous if it enters the bloodstream, destroying heart valves or causing other damage. MRSA is estimated to cause as many as 11,000 U.S. deaths a year.
It's not all bad news. Davis said the patients' risk of contracting MRSA fell by 90% when the dogs were bathed with shampoo containing the antiseptic chlorhexidine prior to the visit and were wiped with disinfectant wipes throughout their hospital visit. She said the results show the programs can continue as long as healthcare facilities keep an eye on certain cleaning and safety protocols.
Pet therapy has been shown to help patients reduce stress and many hospitals have focused their programs on the most vulnerable, such as children and the elderly who also might be most susceptible to the ill effects of acquiring antimicrobial-resistant bacteria.
Dallas-based Baylor Scott & White Health has had a dog therapy program in place for 30 years. Baylor spokeswoman Julie Smith said the program has always followed infection-control guidelines. More than 100 dogs visit their hospitals and clinics and those dogs must be bathed within 24 to 48 hours before each visit. Caregivers must wash their hands before and after every dog encounter with a patient.
Keith Dance, spokesman for San Diego-based Scripps Health, said the system has never had an incident involving the transmission of an antimicrobial-resistant pathogen despite 68 dogs regularly visiting the five-hospital campus. Dance said their protocol requires washing the dogs 24 hours before a visit, patients wiping their hands with antibacterial gel before and after a visit, and prohibiting dogs in intensive-care units or to visit with patients with compromised immune systems.
Hospitals protocols for animal therapy programs tend to follow guidelines issued by the Society for Healthcare Epidemiology of America. Those recommendations include bathing the animal approximately 24 hours prior to a visit, using only dogs because they can be formally trained, and excluding any animal with wounds. Neither SHEA guidelines nor many hospitals' dog therapy policies call for wiping down the dogs with disinfectant throughout the visit.
Davis said she plans begin work on a five-year, randomized clinical trial that will examine whether the results can be replicated in other healthcare settings.
“We're very excited about the potential to understand more about how effective this will be in improving safety for kids over the broad spectrum of the kinds of programs you might see,” Davis said.
The potential of animal therapy visits affecting patients has been raised before. Last year, the American Journal of Infection Control published a study conducted by Tuft University researchers who surveyed 45 hospitals, 45 elder-care facilities, and 27 therapy animal organizations and found wide variety in health and safety policies. It found 4% of hospitals and 22% of elder-care facilities had no policies in place for their animal-assistance programs.