Risks associated with animal-assisted intervention programs: A literature review.
Kathryn R Dalton, Kaitlin B Waite, Kathy Ruble and 9 others
PMID 32379677WHAT IT FOUND
Therapy dogs visiting hospitals carry MRSA and C. difficile more often than those visiting schools.
However, no study proved transmission to patients. Infection control policies vary widely, and handlers often lack training on zoonotic risks.
Key findings
01Therapy dogs with hospital exposure had an incidence rate ratio of 4.7 for MRSA acquisition and 2.4 for C. difficile acquisition compared to those without hospital exposure.
02Infection control policies regarding therapy animals varied across 186 facilities, with 13% to 90% having no existing standardized policies.
03No studies definitively attributed newly-acquired infections to therapy animal visits because there was no control group of hospitalized patients not receiving AAI.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included studies of varying quality, with most epidemiological data coming from small samples (most under 20 animals). There is a severe lack of control groups in patient-level studies, making it impossible to determine if AAI causes infections. Most studies only sampled the animals, not the patients, handlers, or hospital environment, so transmission pathways could not be traced. The literature is heavily skewed towards infectious risks, with almost no empirical data on other hazards like injuries or allergies.
Declared interests
The authors declared no conflicts of interest. The study was not funded by a commercial entity.
The easy way to misread this
Do not assume that therapy animals are safe simply because no infections were directly proven. The lack of evidence for transmission is due to a lack of rigorous studies, not because the risk is zero. The high carriage rates of MRSA and C. difficile in therapy dogs indicate a potential reservoir for pathogens, even if patient-to-patient transmission has not yet been demonstrated.