Drug-resistant bacteria on hand—and in the nursing home

On average, one in four nursing home residents have multidrug-resistant gram-negative bacteria (MDR-GNB), such as E. coli, on their hands.

MDR-GNB can cause infections such as pneumonia, meningitis, bloodstream infections and wood or surgical site infections in an already vulnerable population.

The sobering statistic highlights the need for heightened infection control prevention and control measures, according to findings published in American Journal of Infection Control, the official journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

“Identifying which patients are most prone to an increased risk of MDR-GNB will enable infection preventionists to tailor efforts and stem future contaminations,” researchers from the Columbia University School of Nursing write. “The results of our study suggest that there is much more to be done with regard to infection prevention within nursing homes, and that increased measures must be taken with elderly patients in regard to MDR-GNB colonization.”

The researchers conducted systematic literature and meta-analysis, thought to be the first of its kind. They found specific risk factors associated with increased MDR-GNB colonization risk, including

  • advanced age
  • gender
  • comorbid chronic diseases
  • history of recurrent hospitalization
  • increased interaction with healthcare workers
  • frequent antimicrobial exposure
  • delayed initiation of effective antibiotic therapy
  • presence of medical devices
  • decreased functional status
  • advanced dementia
  • nonambulatory status
  • fecal incontinence
  • severe sepsis present on admission and
  • residency in a long-term care facility.

Among sampled nursing home residents, the prevalence of MDR-GNB colonization ranged from 11.2 percent to 59.1 percent, with a pooled average of 27 percent. The percentage of gram-negative bacteria that are resistant to drugs is increasing at a time when fewer antibacterial treatments are being researched.

Related: Lending a hand to infection control

Topics: Clinical , Infection control