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'Much more to be done' on infection control and prevention in nursing homes

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Around a quarter of nursing home residents are colonised with drug-resistant bacteria, a study by US nurse researchers has suggested.

They said the “significant presence” of multidrug-resistant gram-negative bacteria, such as E. coli, among residents demonstrated a need for better infection control prevention and control measures.

“There is much more to be done with regard to infection prevention within nursing homes”

Sainfer Aliyu

The researchers, from New York’s Columbia University School of Nursing, carried out a systematic literature review and meta-analysis.

They found the prevalence of drug-resistant bacteria colonisation among sampled nursing home residents ranged from 11.2% to 59.1%, with an average of 27%.

The study authors also found nine of the 12 studies involved in the analysis had identified specific factors that were associated with increased colonisation risk from multi-drug resistant bacteria.

Such factors included co-morbid chronic diseases, recurrent admission, frequent interaction with healthcare workers, decreased functional status, advanced dementia, and faecal incontinence.

However, another of the risk factors identified was long-term residency in a care home itself.

Frequent transfers from nursing homes to acute care contribute to the influx of pathogens into hospital settings, noted the study authors in the American Journal of Infection Control.

They acknowledged that the prevention and management of multidrug-resistant gram-negative bacteria in nursing homes were “complicated” due to challenges common to such settings, such as understaffing, fewer resources, insufficient training and inadequate surveillance.

Association for Professionals in Infection Control and Epidemiology

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Linda Greene

“The results of our study suggest that there is much more to be done with regard to infection prevention within nursing homes, said the researchers, who were led by Sainfer Aliyu.

The study is thought to be the first systematic review and meta-analysis of its kind, said the researchers.

They argued that its findings should raise concerns among infection control professionals and nursing home facilities.

Linda Greene, registered nurse and president of the Association for Professionals in Infection Control and Epidemiology, said: “This study underscores the importance of having strong infection prevention programmes in all nursing homes and long-term care facilities.

“Understanding the dynamics and cause of multidrug-resistant gram-negative bacteria transmission is crucial to identifying effective infection control strategies specific to these settings,” she said.


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