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Survey of Long-Term-Care Facilities in Iowa for Policies and Practices Regarding Residents With Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci

Published online by Cambridge University Press:  21 June 2016

Trisha Kreman ,
Jianfang Hu ,
Jean Pottinger  and
Loreen A. Herwaldt
Trisha Kreman
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
Jianfang Hu
Affiliation:
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
Jean Pottinger
Affiliation:
Clinical Outcomes and Resource Management, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Loreen A. Herwaldt*
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa Clinical Outcomes and Resource Management, University of Iowa Hospitals and Clinics, Iowa City, Iowa
*
Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1081[email protected]
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Abstract

Objectives:

To identify infection control policies and practices used by long-term-care facilities (LTCFs) in Iowa for residents with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), and to estimate the prevalence of residents known to have these organisms.

Design:

Survey.

Setting:

LTCFs in Iowa from December 2002 through March 2003.

Results:

Of the 429 LTCFs in Iowa, 331 (77%) responded to the survey. The estimated prevalence of residents known to have MRSA was 13.4 per 1,000 and that of residents known to have VRE was 2.3 per 1,000. Facilities owned by the government or those with an average of more than 86 occupied beds were more likely to have residents known to have MRSA and VRE (P = .002 and .007, respectively). Of the responding facilities, 7.3% acknowledged that they refused to accept individuals known to have MRSA and 16.9% acknowledged that they refused to accept those known to have VRE. Facilities in large communities (population, > 100,000) were least likely to deny admission to an individual known to have either MRSA or VRE (P = .05). Most facilities reported adhering to the national guidelines, but fewer than half (44.7%) of the respondents had heard of the Iowa Antibiotic Resistance Task Force's guidelines regarding residents with MRSA or VRE.

Conclusions:

Many LTCFs in Iowa care for residents known to have MRSA or VRE, but some refuse to admit these individuals. Infection control personnel and public health officials should work together to educate LTCF staff so that residents receive proper care and resistant organisms do not spread within this setting.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 10 , October 2005 , pp. 811 - 815
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention. Issues in Healthcare Settings: Multidrug-Resistant Organisms in Non-Hospital Healthcare Settings. Atlanta, GA: Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention; 2000. Available at www.cdc.gov/ncidod/hip/Aresist/nonhosp.htm. Accessed September 3, 2005.Google Scholar
2.Bradley, SF. Methicillin-resistant Staphylococcus aureus in nursing homes: epidemiology, prevention, and management. Drugs Aging 1997;10:185–198.CrossRefGoogle ScholarPubMed
3.Iowa Department of Public Health. Report of the Iowa Antibiotic Resistance Task Force: A Public Health Guide. Des Moines, IA: Iowa Department of Public Health; 1999. Available at www.idph.state. ia.us/adper/common/pdf/antibioticreport.pdf. Accessed September 3, 2005.Google Scholar
4.Nicolle, LE. Preventing infections in non-hospital settings: long-term care. Emerg Infect Dis 2001;7:205–207.CrossRefGoogle ScholarPubMed
5.Nicolle, LE. Infection control in long-term care facilities. Clin Infect Dis 2000;31:752–756.CrossRefGoogle ScholarPubMed
6.Iowa Department of Inspections and Appeals, Division of Health Facilities. Freestanding nursing facilities/skilled nursing facilities. In: 2005 Direct Care Entities in Iowa. Des Moines, IA: Iowa Department of Inspections and Appeals, Division of Health Facilities; 2005. www.state.ia.us/government/dia. Accessed February 19, 2005.Google Scholar
7.Hospital Infection Control Practices Advisory Committee and the Centers for Disease Control and Prevention. Recommendations for isolation precautions in hospitals. Am J Infect Control 1996;24:24–52.Google Scholar
8.Thurn, JR, Belongia, EA, Crossley, K. Methicillin-resistant Staphylococcus aureus in Minnesota nursing homes. J Am Geriatr Soc 1991;39:1105–1109.CrossRefGoogle ScholarPubMed
9.Ward, TT, Strausbaugh, LJ. Increasing prevalence of methicillin-resistant Staphylococcus aureus in hospitals and nursing homes: the Oregon experience. Infect Med 1992;9:46–51.Google Scholar
10.Mylotte, JM, Karuza, J, Bentley, DW. Methicillin-resistant Staphylococcus aureus: a questionnaire survey of 75 long-term care facilities in western New York. Infect Control Hosp Epidemiol 1992;13:711–718.CrossRefGoogle ScholarPubMed
11.Hsu, CCS. Serial survey of methicillin-resistant Staphylococcus aureus nasal carriage among residents in a nursing home. Infect Control Hosp Epidemiol 1991;12:416–421.CrossRefGoogle ScholarPubMed
12.Murphy, S, Denman, S, Bennett, RG, Greenough, WB, Lindsay, J, Zele-snick, LB. Methicillin-resistant Staphylococcus aureus colonization in a long-term-care facility. ] Am Geriatr Soc 1992;40:213–217.CrossRefGoogle ScholarPubMed
13.Trick, WE, Kuehnert, MJ, Quirk, SB, et al.Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients. J Infect Dis 1999;180:391–396.CrossRefGoogle ScholarPubMed
14.Elizaga, ML, Weinstein, RA, Hayden, MK. Patients in long-term care facilities: a reservoir for vancomycin-resistant enterococci. Clin Infect Dis 2002;34:441–446.CrossRefGoogle ScholarPubMed
15.Mulhausen, PL, Harrell, LJ, Weinberger, M, Kochersberger, GG, Feuss-ner JR. Contrasting methicillin-resistant Staphylococcus aureus colonization in Veterans Affairs and community nursing homes. Am J Med 1996;100:24–31.CrossRefGoogle ScholarPubMed
16.Bryce, EA, Fiffin, SM, Isaac-Reton, JL, Wright, CJ. Evidence of delays in transferring patients with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus to long-term-care facilities. Infect Control Hosp Epidemiol 2000;21:270–271.CrossRefGoogle ScholarPubMed
17.Trick, WE, Weinstein, RA, Demarais, PL, et al.Colonization of skilled-care facility residents with antimicrobial-resistant pathogens. J Am Geriatr Soc 2001;49:270–276.CrossRefGoogle ScholarPubMed
18.Loeb, MB, Craven, S, McGeer, AI, et al.Risk factors for resistance to antimicrobial agents among nursing home residents. Am J Epidemiol 2003;157:40–47.CrossRefGoogle ScholarPubMed