The SHIELD Orange County Project -Multi Drug-Resistant Organism (MDRO) Prevalence in 21 Nursing Homes and Long Term Acute Care Facilities in Southern California.
Document Type
Article
Publication Date
2-11-2019
Publication Title
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Abstract
Background: Multidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NH), and long-term acute care facilities (LTACs) via patient transfers. SHIELD OC is a regional public health collaborative involving decolonization at 38 healthcare facilities selected based upon their high degree of patient sharing. We report baseline MDRO prevalence in 21 NH/LTACs.
Methods: A random sample of 50 adults for 21 NH/LTACs (18 NHs, 3 LTACs) were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE) using nares, skin (axilla/groin), and peri-rectal swabs. Facility and resident characteristics associated with MDRO carriage were assessed using multivariable models clustering by person and facility.
Results: Prevalence of MDROs was 65% in NHs and 80% in LTACs. The most common MDROs in NHs were MRSA (42%) and ESBL (34%); in LTACs they were VRE (55%) and ESBL (38%). CRE prevalence was higher in facilities that manage ventilated LTAC patients and NH residents (8% vs.
Conclusions: The majority of NH residents and LTACs patients harbor MDROs. MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NH/LTACs as part of regional efforts to control MDRO spread.
Department
Quality
Department
Infectious Diseases
Recommended Citation
McKinnell, James A; Singh, Raveena D; Miller, Loren G; Kleinman, Ken; Gussin, Gabrielle; He, Jiayi; Saavedra, Raheeb; Dutciuc, Tabitha D; Estevez, Marlene; Chang, Justin; Heim, Lauren; Yamaguchi, Stacey; Custodio, Harold; Gohil, Shruti K; Park, Steven; Tam, Steven; Robinson, Philip A; Tjoa, Thomas; Nguyen, Jenny; Evans, Kaye D; Bittencourt, Cassiana E; Lee, Bruce Y; Mueller, Leslie E; Bartsch, Sarah M; Jernigan, John A; Slayton, Rachel B; Stone, Nimalie D; Zahn, Matthew; Mor, Vincent; McConeghy, Kevin; Baier, Rosa R; Janssen, Lynn; O'Donnell, Kathleen; Weinstein, Robert A; Hayden, Mary K; Coady, Micaela H; Bhattarai, Megha; Peterson, Ellena M; and Huang, Susan S, "The SHIELD Orange County Project -Multi Drug-Resistant Organism (MDRO) Prevalence in 21 Nursing Homes and Long Term Acute Care Facilities in Southern California." (2019). Articles, Abstracts, and Reports. 1154.
https://digitalcommons.providence.org/publications/1154
