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In a recent article appearing in the May issue of the “American Journal of Infection Control,” the study’s author, Sainfer Aliyu of the Columbia University School of Nursing found that the incidence of multidrug-resistant gram-negative bacteria (MDR-GNB) such as E. coli in America’s nursing home population ranged from 11.2 percent to 59.1 percent, with a pooled average of 27 percent among sampled nursing home residents.
This means, quite simply, that more than one in four nursing home residents have been exposed to bacteria for which there is no known antibiotic available to treat infections resulting from these organisms.
Significant risk factors common in nursing home populations, such as chronic diseases, history of recurrent hospitalizations, more frequent interaction with healthcare workers, delayed initiation of effective antibiotic therapy, decreased functional status, fecal incontinence and exposure to other pathogens in skilled nursing facilities, compound the problem and should, according to the study’s author, raise significant concerns among infection control professionals and nursing home facilities.
Adding to the challenge that this study highlights regarding the need for more effective infection control in nursing homes are the chronic problems of the nursing home industry, including understaffing, inadequate resources, and insufficient training of nursing home personnel in even common hygiene precautions.
If you have a family member residing in a skilled nursing facility, observe the nurses and nursing assistants who are providing care for residents in the facility. Do staff members wash their hands after providing care to one resident before caring for another resident? Are there other procedures in place at the facility to prevent cross-contamination of the resident population? If not, raise your concerns with the Director of Nursing or the Administrator. Alternatively, attend a resident council meeting and voice your concerns at the meeting. If you notice no improvement, report the facility to the Department of Public Health.
The presence of drug-resistant bacteria in our nation’s skilled nursing facilities is a pressing problem, and one which is sure to worsen as our population ages, if not effectively combated by better infection control measures.