Safety and Efficacy Validation
We observed 2383 HCP at random on entry to contact precautions rooms, 1194 in direct-gloving units and 1189 in usual care units, and we sampled their gloves for bacteria before room entry. Pathogens were identified in 49 of 1194 (4%) samples obtained from the direct-gloving units, with a mean (SD) total bacterial colony count of 16.3 (45.9) colony-forming units (CFUs), whereas 28 of 1189 (2%) samples obtained in usual care units had pathogens identified, with a mean of 9.5 (33.2) CFUs. Overall, pathogenic bacteria among the different types of units ranged from 1% to 4% and overall bacterial burden ranged from 5.3 to 12.1 CFUs. In the pediatrics unit, the direct-gloving policy had a protective effect on total colony counts (adjusted incidence RR, 0.34; 95% CI, 0.19-0.63). However, the ED had a higher prevalence of pathogenic bacteria (13%) and greater bioburden (52.8 CFUs) in the direct-gloving units (