New research indicates that multidrug-resistant bacteria such as E. coli are found in more than a quarter of people living in nursing homes.
In a review of eight earlier studies, the researchers reported rates ranged from 11 percent of residents to an alarming 59 percent. The average was 27 percent, HealthDay reports.
Study author Sainfer Aliyu, a doctoral candidate at Columbia University School of Nursing, said, “Nursing home residents are at higher risk to become colonized with these bacteria.” Residents colonized with the bacteria may not show symptoms of an illness or even know they have the bacteria, but they can spread the bacteria to others, Aliyu said.
The study, which was published in the May issue of the American Journal of Infection Control, focused on multidrug-resistant gram-negative bacteria (MDR-GNB) in nursing home residents. Infections with these types of bacteria are common in nursing homes, the study authors report.
Health officials are concerned about the rising number of infections resistant to carbapenems—the powerful last-resort antibiotics. The Centers for Disease Control and Prevention (CDC) says the percentage of multidrug-resistant gram-negative bacteria is increasing. MDR-GNB cause infections including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. These infections are becoming resistant to nearly all available drugs and fewer new antibiotics being developed.
The attorneys at Parker Waichman have advised individuals with hospital-acquired drug-resistant infections and can provide information for nursing home residents and their families.
Nursing Home Residents at Greater Risk for MDR-GNB
Nursing home residents often have weakened immune systems, and many are taking lengthy courses of antibiotics, which contributes to antibiotic-resistance, HealthDay notes. Residents share common spaces like dining rooms and day rooms on a daily basis. In their interactions with each other they give bacteria a chance to move from person to person.
The researchers analyzed eight studies on MDR-GNB in nursing home residents done between 2005 and 2016. According to Aliyu, the study shows the need to “further educate staff on infection prevention,” and to find “policies for infection prevention that are more nursing-home specific.”
Infectious-disease specialist Linda Greene, a nurse and president-elect of the Association for Professionals in Infection Control and Epidemiology, praised the study. Greene said it is hard to know the colonization rates in the general community. She notes that the rates seen in nursing homes are likely higher than in hospitals, because the nursing home residents interact with one another in ways hospital patients do not. The challenge in this setting is how to lower the bacterial colonization rate without isolating residents.
Nursing home residents are particularly vulnerable to infections because of advanced age, multiple illnesses, and weakened immune systems. Prevention and management of MDR-GNB in nursing homes is a challenge because nursing homes are often understaffed, have limited resources, and insufficient training and inadequate surveillance, the Columbia University School of Nursing explains in a news release.
Dr. David Gifford, senior vice president of quality and regulatory affairs for the American Health Care Association, a long-term care facilities trade group, says that hand washing is an important practice for preventing infection, not only in nursing homes, but in all health care settings. Gifford says people should make sure that every health care provider who examines or treats them has washed his or her hands before the treatment starts.
Gifford said it’s hard to know where people became colonized with difficult-to-treat bacteria. “Some probably originated in the nursing homes, some in hospitals . . . Ninety percent of admissions to nursing homes come from a hospital.” According to Gifford, the study findings “reflect the fact that—in the U.S. in particular—we administer antibiotics much more frequently than is necessary. As you give out more and more antibiotics, you’re going to develop more antibiotic resistance.” Overprescribing of antibiotics is “a real and serious threat in the U.S.” Many children and adults are given antibiotics for viruses, which they cannot treat. Gifford said changing antibiotic prescribing is as important as on-site infection controls in nursing homes and health care facilities.
Facilities need to work together to combat the problem, Greene said. Communication between facilities needs to improve. For example, if someone is admitted to a nursing home while taking antibiotics, it’s important that the person finishes the full course of medication.
Help for Nursing Home Residents with Drug-Resistant Infections
If you or a family member has acquired a drug-resistant infection in a nursing home, the attorneys at Parker Waichman LLP can help evaluate your legal rights. To reach the firm, fill out the contact form or call 1-800-YOURLAWYER (1-800-968-7529).