The study, published April 1 in JAMA, analyzed quality improvements across 35 healthcare facilities in Orange County, Calif., between July 2017 and July 2019. The study analyzed methods of decolonization associated with reducing regional multidrug-resistant organisms prevalence, incident clinical cultures, and infection-related hospitalizations, costs and deaths. Of the 35 facilities in the study, 16 were hospitals, 16 were nursing homes and three were long-term acute care hospitals.
The study looked at regional interventions to mitigate multidrug-resistant organisms and associated infections. Here are four findings:
- At facilities that adopted the intervention, The mean prevalence of multidrug-resistant organisms decreased from 63.9% to 49.9% among nursing homes, from 80% to 53.3% among long-term care hospitals and from 64.1% to 55.4% among hospitalized patients in hospitals.
- A patient cleansing protocol, known as decolonization, at nursing homes helped reduce monthly incident MDRO-positive clinical cultures from 2.7 to 1.7, compared to a change of 1.7 to 1.5 among non-participating nursing homes.
- The rate of infection-related hospitalizations per 1,000 resident-days dropped from 2.31 to 1.94 during intervention.
- Associated hospitalization costs per 1,000 resident-days dropped from $64,651 to $55,149 among participating nursing homes, compared to a roughly $4,000 increase for non-participating nursing homes.
“A regional collaborative involving universal decolonization in long-term care facilities and targeted decolonization among hospital patients in contact precautions was associated with lower multidrug-resistant organism carriage, infections, hospitalizations, costs and deaths,” the study authors wrote.
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