Closeup image of gloved hands spraying surface with disinfectant for infection control

Two common types of antibiotic-resistant bacteria linger in nursing homes, putting vulnerable residents at risk of infection despite cleanings — and even during changes of occupancy, according to a new facility study.

Frail nursing home residents are especially endangered by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), according to the researchers. To assess the prevalence of these bugs in facilities, they performed environmental screenings of nine single-occupancy rooms in one nursing home over 34 weeks.

During that time, high-touch surfaces were swabbed three times weekly. Residents who consented to participate also received testing of their nostrils, groin and hands. 

The study captured more than 16.5 average occupancies per room. When more than 4,600 swabs results were analyzed at the end of the study period, results showed that all rooms had been contaminated with VRE at least once, and that the same was true of MRSA in 8 of the 9 rooms.

New contamination

Judging from the many diverse strains of MRSA and VRE detected, there were multiple introductions of these organisms to the facility, the investigators reported. In fact, new contamination was likely in 23% of 185 opportunities for detection. There also was potential for lingering contamination during occupancy changes, they added. Three cases of infections that persisted during occupancy changes were confirmed, with six other possible instances.

The results underscore the need for active surveillance screening and to regularly evaluate infection control cleaning procedures, the study team concluded.

Full findings were published in the journal Antimicrobial Stewardship & HealthCare Epidemiology.

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