Multidrug-resistant organisms (MDROs) are infectious microbes, usually bacteria, that are resistant to multiple antibiotics and antimicrobial therapies and are of particular concern in nursing homes. Patient isolation effectiveness has been studied in acute care settings, but is not well established in nursing homes. Decisions to use isolation in nursing homes depend on factors such as the environment, resident, and system characteristics, many of which are perception driven rather than evidence-based, creating substantial variation in clinical practice. To examine resident and system characteristics associated with isolation for MDRO-infected patients, researchers analyzed national data of MDRO-positive residents in nursing homes. The analysis revealed that isolation was used infrequently and that there was wide variation among nursing homes in the proportion of MDRO-infected residents in isolation, with many nursing homes having no isolation for MDRO-infected patients. Resident characteristics that were positively associated with isolation included increased needs for support with eating and general mobility. Nursing homes that received an infection control-related citation within the past year were more likely to use isolation, while nursing homes that had received a quality-of-care citation had lower isolation use. These findings have implications for informing training strategies, establishing appropriate policies, and defining future research areas to determine whether and when isolation should be used to best decrease risk of MDRO transmission, while also improving quality of care.
Cohen CC, Dick A, Stone PW. Isolation Precautions Use for Multidrug-Resistant Organism Infection in Nursing Homes. J Am Geriatr Soc. 2017 Mar;65(3):483-489. PMID: 28211567