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Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States
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Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States
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Journal Article
Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States
2025
Overview
Nursing home (NH) residents in the United States routinely attend interactive visits for services such as therapy or dialysis, creating opportunities for pathogen transmission. A paucity of studies exist which delineate spread of pathogens beyond residents’ in-room environment. In this prospective cohort study, we recruited 197 newly-admitted residents across three Veterans Affairs NHs to characterize multidrug-resistant organism (MDRO) prevalence, acquisition, and transmission. Participant hands, nares, groin, and seven environmental surfaces were swabbed during 758 regularly scheduled in-room visits; participant hands, healthcare personnel hands, and equipment were swabbed during 345 unscheduled interactive visits. We demonstrate that baseline MDRO colonization and new acquisition is common, and one in six interactive visits result in MDRO transmission. Whole genome sequencing on a subset of participants enabled us to identify sources of transmission where it was unknown using microbiologic methods alone. Our results illustrate MDRO transmission pathways and highlight the need for innovative, multidisciplinary interventions.
Nursing homes are high-risk settings for transmission of infections, but risks associated with specific activities are not well understood. Here, the authors investigate transmission dynamics of multi-resistant organisms in nursing homes in the United States with a focus on out-of-room, interactive visits.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ Aged
/ Anti-Bacterial Agents - pharmacology
/ Cross Infection - epidemiology
/ Cross Infection - microbiology
/ Cross Infection - transmission
/ Dialysis
/ Drug Resistance, Multiple, Bacterial - genetics
/ Female
/ Humanities and Social Sciences
/ Humans
/ Male
/ Multidrug resistant organisms
/ Nursing Homes - statistics & numerical data
/ Science
