41% of multi-drug resistant infections are acquired when nursing home residents are hospitalized, mo

A significant proportion of multi-drug resistant infections in nursing homes originate in acute care hospitals, indicating that greater coordination between settings is needed, according to recently published findings.

The nursing home itself is the most likely place for a resident to acquire this type of infection, but many also get infected during stints in the hospital, the investigators determined. Among residents infected during the 2010 to 2011 study period, 41% picked up the multi-drug resistant organism in an acute care hospital, compared with 57% infected while in the nursing home.

Because hospitals “are not too far behind” nursing homes as infection sites, and because transfers between the settings are common, greater coordination is needed to effectively control these potentially fatal infections, the study authors wrote. They reached their conclusions by analyzing Minimum Data Set information for the nation’s roughly 4.1 million nursing home residents over a 15-month period.

The Northeast has the highest MDRO prevalence rate regionally, while South has the lowest, the investigators found. The regional patterns reflect the finding that more densely populated urban areas have a higher prevalence rate than rural areas, although the study authors did not make a direct linkage. Men, younger residents, and residents of American Indian or Native Alaskan heritage also had higher infection rates.

Full findings appear in the October 2014 issue of Infection Control and Hospital Epidemiology. The authors were affiliated with a variety of institutions, including the American Institutes for Research and the University of Missouri School of Medicine.

The White House recently announced a national strategy for combating antibiotic-resistant infections. Possible steps include requiring long-term care facilities to implement antibiotic stewardship programs to take part in Medicare and Medicaid.