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Multidrug-Resistant Organism Infections in US Nursing Homes: A National Study of Prevalence, Onset, and Transmission across Care Settings, October 1, 2010-December 31, 2011

Published online by Cambridge University Press:  10 May 2016

Daver Kahvecioglu ,
Kalpana Ramiah ,
Darcy McMaughan ,
Steven Garfinkel ,
Veronica E. McSorley ,
Quy Nhi Nguyen ,
Manshu Yang ,
Christopher Pugliese ,
David Mehr  and
Charles D. Phillips
Daver Kahvecioglu
Affiliation:
Fannie Mae, Washington, DC
Kalpana Ramiah
Affiliation:
American Institutes for Research, Washington, DC
Darcy McMaughan
Affiliation:
Texas A&M University, School of Public Health, College Station, Texas
Steven Garfinkel
Affiliation:
American Institutes for Research, Washington, DC
Veronica E. McSorley
Affiliation:
American Institutes for Research, Washington, DC
Quy Nhi Nguyen
Affiliation:
American Institutes for Research, Washington, DC
Manshu Yang
Affiliation:
American Institutes for Research, Washington, DC
Christopher Pugliese
Affiliation:
American Institutes for Research, Washington, DC
David Mehr
Affiliation:
University of Missouri, School of Medicine, Columbia, Missouri
Charles D. Phillips
Affiliation:
Texas A&M University, School of Public Health, College Station, Texas
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Objective.

To understand the prevalence of multidrug-resistant organism (MDRO) infections among nursing home (NH) residents and the potential for their spread between NHs and acute care hospitals (ACHs).

Methods.

Descriptive analyses of MDRO infections among NH residents using all NH residents in the Long-Term Care Minimum Data Set (MDS) 3.0 between October 1, 2010 and December 31, 2011.

Results.

Analysis of MDS data revealed a very high volume of bidirectional patient flow between NHs and ACHs, indicating the need to study MDRO infections in NHs as well as in hospitals. A total of 4.24% of NH residents had an active MDRO diagnosis on at least 1 MDS assessment during the study period. This rate significantly varied by sex, age, urban/rural status, and state. Approximately 2% of NH discharges to ACHs involved a resident with an active diagnosis of infection due to MDROs. Conversely, 1.8% of NH admissions from an ACH involved a patient with an active diagnosis of infection due to MDROs. Among residents who acquired an MDRO infection during the study period, 57% became positive in the NH, 41% in the ACH, and 2% in other settings (eg, at a private home or apartment).

Conclusion.

Even though NHs are the most likely setting where residents would acquire MDROs after admission to an NH (accounting for 57% of cases), a significant fraction of NH residents acquire MDRO infection at ACHs (41%). Thus, effective MDRO infection control for NH residents requires simultaneous, cooperative interventions among NHs and ACHs in the same community.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue S3: Preventing Healthcare–Associated Infections: Results and Lessons Learned from AHRQ's HAI Program , October 2014 , pp. S48 - S55
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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