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Healthcare-Associated Pathogens and Nursing Home Policies and Practices: Results From a National Survey

  • Zhiqiu Ye (a1), Dana B. Mukamel (a2), Susan S. Huang (a3), Yue Li (a1) and Helena Temkin-Greener (a1)...



To examine the prevalence of healthcare-associated pathogens and the infection control policies and practices in a national sample of nursing homes (NHs).


In 2012, we conducted a national survey about the extent to which NHs follow suggested infection control practices with regard to 3 common healthcare-associated pathogens: methicillin-resistant Staphylococcus aureus, Clostridium difficile, and extended-spectrum β-lactamase producers, and their prevalence in NHs. We adapted a previously used and validated NH infection control survey, including questions on prevalence, admission and screening policies, contact precautions, decolonization, and cleaning practices.


A total of 1,002 surveys were returned. Of the responding NHs, 14.2% were less likely to accept residents with methicillin-resistant Staphylococcus aureus, with the principal reason being lack of single or cohort rooms. NHs do not routinely perform admission screening (96.4%) because it is not required by regulation (56.2%) and would not change care provision (30.7%). Isolation strategies vary substantially, with gloves being most commonly used. Most NHs (75.1%) do not decolonize carriers of methicillin-resistant Staphylococcus aureus, but some (10.6%) decolonize more than 90% of residents. Despite no guidance on how resident rooms on contact precautions should be cleaned, 59.3% of NHs report enhanced cleaning for such rooms.


Overall, NHs tend to follow voluntary infection control guidelines only if doing so does not require substantial financial investment in new or dedicated staff or infrastructure.

Infect Control Hosp Epidemiol 2015;36(7):759–766


Corresponding author

Address correspondence to Helena Temkin-Greener, PhD, Department of Public Health Science, University of Rochester Medical Center, 265 Crittenden Blvd, CU420644, Rochester, NY 14642 (


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Presented in part: American Public Health Association Annual Meeting; Boston, Massachusetts; November 5, 2013 (Abstract 278035).



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Healthcare-Associated Pathogens and Nursing Home Policies and Practices: Results From a National Survey

  • Zhiqiu Ye (a1), Dana B. Mukamel (a2), Susan S. Huang (a3), Yue Li (a1) and Helena Temkin-Greener (a1)...


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