Skip to main content Accessibility help
×
Home
Hostname: page-component-5d6d958fb5-z6b88 Total loading time: 0.227 Render date: 2022-11-27T12:33:10.270Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Can alternative anatomical sites and environmental surveillance replace perianal screening for multidrug-resistant organisms in nursing homes?

Published online by Cambridge University Press:  21 May 2021

Kyle J. Gontjes*
Affiliation:
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
Kristen E. Gibson
Affiliation:
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Bonnie Lansing
Affiliation:
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Marco Cassone
Affiliation:
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Lona Mody
Affiliation:
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan Geriatrics Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
*
Author for correspondence: Kyle Gontjes, E-mail: kgontjes@umich.edu

Abstract

Perianal screening can be intrusive. The sensitivities of multianatomical, nonperianal surveillance were 92.3% for methicillin-resistant Staphylococcus aureus (MRSA), 58.7% for vancomycin-resistant enterococci (VRE), and 54.9% for resistant Gram-negative bacilli (R-GNB). Sensitivities improved upon adding environmental surveillance (95.5%, 82.9%, and 67.9%, respectively). Multianatomical, nonperianal screening and room environment surveillance may replace perianal screening and reduce healthy participant bias in nursing homes.

Type
Concise Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION: Preliminary findings from this manuscript were accepted for SHEA Decennial 2020 and presented at IDWeek 2020, October 22–26, 2020, conducted virtually.

References

Cassone, M, Mody, L. Colonization with multidrug-resistant organisms in nursing homes: scope, importance, and management. Curr Geriatr Rep 2015;4:8795.CrossRefGoogle Scholar
Montoya, A, Cassone, M, Mody, L. Infections in nursing homes: epidemiology and prevention programs. Clin Geriatr Med 2016;32:585607.CrossRefGoogle ScholarPubMed
Mody, L, Foxman, B, Bradley, S, et al. Longitudinal assessment of multidrug-resistant organisms in newly admitted nursing facility patients: implications for an evolving population. Clin Infect Dis 2018;67:837844.Google ScholarPubMed
Charlson, M, Szatrowski, TP, Peterson, J, Gold, J. Validation of a combined comorbidity index. J Clin Epidemiol 1994;47:12451251.CrossRefGoogle ScholarPubMed
Lawton, MP, Brody, EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179186.CrossRefGoogle ScholarPubMed
Saliba, D, Buchanan, J. Development and Validation of a Revised Nursing Home Assessment Tool: MDS 3.0. Santa Monica, CA: Rand Health, 2008.Google Scholar
Tripepi, G, Jager, KJ, Dekker, FW, Zoccali, C. Selection bias and information bias in clinical research. Nephron Clin Pract 2010;115(2):c949.CrossRefGoogle ScholarPubMed
Lam, HR, Chow, S, Taylor, K, et al. Challenges of conducting research in long-term care facilities: a systematic review. BMC Geriatr 2018;18:242.CrossRefGoogle ScholarPubMed
Weinstein, JW, Tallapragada, S, Farrel, P, Dembry, LM. Comparison of rectal and perirectal swabs for detection of colonization with vancomycin-resistant enterococci. J Clin Microbiol 1996;34:210212.CrossRefGoogle ScholarPubMed
Lautenbach, E, Harris, AD, Perencevich, EN, Nachamkin, I, Tolomeo, P, Metlay, JP. Test characteristics of perirectal and rectal swab compared to stool sample for detection of fluoroquinolone-resistant Escherichia coli in the gastrointestinal tract. Antimicrob Agents Chemother 2005;49:798800.CrossRefGoogle ScholarPubMed
Kim, JJ, Johnson, JK, Stucke, EM, et al. Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves. Infect Control Hosp Epidemiol 2020;41:13961401.CrossRefGoogle ScholarPubMed
Cassone, M, Mantey, J, Perri, MB, et al. Environmental panels as a proxy for nursing facility patients with methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus colonization. Clin Infect Dis 2018;67: 861868.CrossRefGoogle ScholarPubMed
Supplementary material: File

Gontjes et al. supplementary material

Figures S1 and S2

Download Gontjes et al. supplementary material(File)
File 652 KB

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Can alternative anatomical sites and environmental surveillance replace perianal screening for multidrug-resistant organisms in nursing homes?
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Can alternative anatomical sites and environmental surveillance replace perianal screening for multidrug-resistant organisms in nursing homes?
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Can alternative anatomical sites and environmental surveillance replace perianal screening for multidrug-resistant organisms in nursing homes?
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *