Nursing home residents admitted to the hospital for sepsis have high rates of multidrug-resistant bloodstream infections, putting them at risk for a host of adverse outcomes — including longer stays in an intensive care unit, a new study has determined.

Among all adults admitted from skilled nursing care to a large medical center for sepsis between 2015 and 2018, fully 47% received a diagnosis of a multidrug-resistant organism bloodstream infection, or MDRO-BSI, reported senior author Seife Yohannes, M.D., of MedStar Washington Hospital Center, Washington, D.C. 

Intensive care unit length of stay was longer in these patients — at seven days versus five days — and total costs were more than $23,000 versus $17,900 when compared with their peers who did not develop an MDRO-BSI. Those patients also were twice as likely to initially receive the wrong empiric anti-infective therapy and were significantly more likely to die, Yohannes and colleagues reported

The authors also looked at the prevalence of the organisms causing the residents’ infections. They found Staphylococcus aureus in 24% of patients, Escherichia coli in 14%, Proteus mirabilis in 13%, Staphylococcus epidermidis in 8%, Enterococcus faecalis in 7%, and Klebsiella pneumoniae in 6%. 

Although it is well known that nursing home residents have a high prevalence of MDRO-BSI, the current study adds more information about the overall effect of these infections, and new information about the prevalence of the infectious organisms in this population, Yohannes and colleagues concluded.

The study was published in the Journal ofIntensive Care Medicine.