Facilities need better reviews of antibiotic use, expert says

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Gail Bennett says that good hand hygiene is a must against MDROs.
Gail Bennett says that good hand hygiene is a must against MDROs.

Skilled nursing facility administrators need to do a complete review of antibiotics to better combat multi-drug resistant organisms, an infection control expert said in May.

“If you don't look, you don't know,” warned Gail Bennett, MSN, RN, CIC, co-founder of ICP Associates, at the Life Services Network Annual Meeting in Chicago. “What may be needed is an antibiotic stewardship program in order to make sure it's the right drug at the right dosage.” 

Antibiotic overuse has resulted in new strains of multi–drug resistant organisms, which hit long-term care residents particularly hard. These include Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), and Carbapenem-resistant Enterobacteriaceae (CRE). The last is considered highly dangerous to residents, and during treatment, “tigecycline as the only thing left,” Bennett noted.

Still, MRSA is more prevalent, as its the second most common overall cause of healthcare-associated infections. In a MRSA outbreak, staff cultures will sometimes be taken to determine whether they have nasal colonization. But that's a big “if,” Bennett cautioned.

“CDC tells us not to routinely culture,” she said. “It's a dangerous place to go.”

For all MRDOs, strong environmental cleaners are needed, with special attention to areas that are “high-touch,” she added.