Prevalence of and Factors Associated With Multidrug Resistant Organism (MDRO) Colonization in 3 Nursing Homes

Abstract

Nursing home residents are at risk for acquiring and transmitting MDROs. A serial point-prevalence study of 605 residents in 3 facilities using random sampling found MDRO colonization in 45% of residents: methicillin-resistant Staphylococcus aureus (MRSA, 26%); extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL, 17%); vancomycin-resistant Enterococcus spp. (VRE, 16%); carbapenem-resistant Enterobacteriaceae (CRE, 1%). MDRO colonization was associated with history of MDRO, care needs, incontinence, and catheters. Infect Control Hosp Epidemiol 2016;1485-1488.

The SHIELD Orange County Project: Multidrug-resistant Organism Prevalence in 21 Nursing Homes and Long-term Acute Care Facilities in Southern California

“…[7-9, 15, 16, 18, 19, 37-41] Our study is strengthened by the fact that our surveillance was systematic and included tests for peri-rectal colonization, which have not been universally done in other settings. [39] Our study is further strengthened by the low refusal rate of 8% for the point prevalence study and our ability to conduct all patient sampling for all but four facilities in a single day. The low refusal rate and true single day point prevalence estimates suggest that our data are likely representative of the nursing home and LTAC populations.…”

Longitudinal Assessment of Multidrug-Resistant Organisms in Newly Admitted Nursing Facility Patients: Implications for an Evolving Population

“…First, as all participating NFs were located in metropolitan Detroit; the results may not be generalizable to other regions of the country. However, epidemiological investigations in NFs across the nation have also shown a high prevalence and new acquisition of MDROs [7,8,[14][15][16]. Second, as none of these facilities are physically connected to a hospital and because informed consent was required, our study protocol permitted us to obtain enrollment and discharge samples for a period longer than the standard 3-day window required in acute care MDRO research.…”

“…Even when not actively causing infection, MDRO colonization has the potential for transmission from patient to patient and increases the risk of clinically significant infection among those colonized [7][8][9][10]. However, the MDRO colonization status is often unknown and routine implementation of MDRO surveillance and isolation procedures is challenging and costly [11].…”

Infrequent Use of Isolation Precautions in Nursing Homes: Implications for an Evolving Population

“…With rates exceeding those in acute care hospitals, including intensive care units, over 50% of nursing home residents harbor a multi‐drug resistant organism (MDRO) without having any symptoms of infection . When a nursing home resident develops a symptomatic infection, it is often caused by an MDRO .…”

“…W ith rates exceeding those in acute care hospitals, including intensive care units, over 50% of nursing home residents harbor a multi-drug resistant organism (MDRO) without having any symptoms of infection. [1][2][3][4][5][6][7][8] When a nursing home resident develops a symptomatic infection, it is often caused by an MDRO. 9 Guidance from the Centers for Disease Control and Prevention on the use of isolation practices in nursing homes suggests modified contact precautions based on case-mix.…”