Antibiotic exposure and dirty hands were factors linked to nursing home contamination with the multidrug-resistant bacteria vancomycin-resistant Enterococci, or VRE, a new study finds.

The report was published in this month’s edition of The Lancet Health Longevity.

It details a study performed by researchers with the University of Michigan Medical School, who wanted to look at what characteristics were linked to nursing home contamination with VRE.

Most long-term care communities try to stop the spread of VRE and pathogens like it; facility leaders promote hand hygiene and other practices. The researchers wanted to see whether they could stop VRE transmission by pinpointing the factors that may make it more likely for residents to shed and spread VRE. 

The team collected data from 245 participants at six nursing homes in the United States. The researchers evaluated cultures from their bodies and their rooms during multiple visits. Of the participants, VRE was present in 49 of the people, and environmental contamination was found for 36 of the people.

According to the analysis, men and people taking antibiotics were more prone to environmental contamination from other residents with VRE. People who were more physically dependent had a reduced risk for environmental contamination.

“Our results support a model of VRE transmission in nursing homes whereby colonized residents with sufficient physical independence can contaminate their environment via their hands, which is likely to increase the chance of a resident with an antibiotic-disrupted microbiota acquiring VRE colonization, either directly from the contaminated environment or via a health-care worker intermediate,” the authors wrote in the paper.

Nursing home leaders and other infection prevention professionals may want to target hand hygiene and antibiotic stewardship practices as a way to try and lower VRE contamination and transmission, the authors said.