학술논문
When a Home is Not a Home: MultiDrug-Resistant Organism (MDRO) Colonization and Environmental Contamination in 28 Nursing Homes (NHs)
Document Type
article
Author
McKinnell, James A; Miller, Loren; Singh, Raveena D; Mendez, Job; Franco, Ryan; Gussin, Gabrielle; Chang, Justin; Dutciuc, Tabitha D; Saavedra, Raheeb; Kleinman, Ken; Peterson, Ellena M; Evans, Kaye D; Heim, Lauren; Miner, Aaron; Estevez, Marlene; Custodio, Harold; Yamaguchi, Stacey; Nguyen, Jenny; Varasteh, Alex; Launer, Bryn; Agrawal, Shalini; Tjoa, Thomas; He, Jiayi; Park, Steven; Tam, Steven; Gohil, Shruti K; Stone, Nimalie D; Steinberg, Karl; Montgomery, Jocelyn; Beecham, Nancy; Huang, Susan S
Source
Open Forum Infectious Diseases. 4(suppl_1)
Subject
Language
Abstract
Abstract Background The majority of healthcare-associated infections due to MDROs occur in the post-discharge setting. Understanding MDRO spread and containment in NHs can help identify infection prevention activities needed to care for vulnerable patients in a medical home setting. Methods We conducted a baseline point prevalence study of MDRO colonization in residents of 28 Southern California NHs participating in a decolonization trial. In Fall 2016, residents were randomly sampled to obtain a set of 50 nares and skin (axilla/groin) swabs from each NH. Nasal swabs were processed for MRSA and skin swabs were processed for MRSA, VRE, ESBL, and CRE. In addition, environmental swabs were collected from high touch objects in resident rooms (bedrail, call button/TV remote, door knobs, light switch, bathroom) and common areas (nursing station, table, chair, railing, and drinking fountain). Results A total of 2,797 body swabs were obtained from 1400 residents. Overall, 48.6% (N = 680) of residents harbored MDROs. MRSA was found in 37% of residents (29.5% nares, 24.4% skin), followed by ESBL in 16% (Table 1). Resident MDRO status was only known for 11% of MRSA (59/518), 18% ESBL (40/228), 4% VRE (4/99), and none of the CRE (0/13) carriers. Colonization did not differ between long stay (48.8%, 534/1094) vs. post-acute (47.7%, 146/306) residents (P = NS), but bedbound residents were more likely to be MDRO colonized (58.7%, 182/310) vs. ambulatory residents (45.7%, 497/1088, P