Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States
Nursing home (NH) residents in the United States routinely attend interactive visits for services such as therapy or dialysis, creating opportunities for pathogen transmission. A paucity of studies exist which delineate spread of pathogens beyond residents' in-room environment. In this prospective cohort study, we recruited 197 newly-admitted residents across three Veterans Affairs NHs to characterize multidrug-resistant organism (MDRO) prevalence, acquisition, and transmission. Participant hands, nares, groin, and seven environmental surfaces were swabbed during 758 regularly scheduled in-room visits; participant hands, healthcare personnel hands, and equipment were swabbed during 345 unscheduled interactive visits. We demonstrate that baseline MDRO colonization and new acquisition is common, and one in six interactive visits result in MDRO transmission. Whole genome sequencing on a subset of participants enabled us to identify sources of transmission where it was unknown using microbiologic methods alone. Our results illustrate MDRO transmission pathways and highlight the need for innovative, multidisciplinary interventions.
Authors
- Mary R. Janevic (ORCID: https://orcid.org/0000-0001-5782-4893)
- Sanjay K. Saint (ORCID: https://orcid.org/0000-0002-9579-6990)
- Lona Mody (ORCID: https://orcid.org/0000-0002-0260-8007)
- Todd Greene
- Federico Perez (ORCID: https://orcid.org/0000-0003-2642-3266)
- Ganga Vijayasiri (ORCID: https://orcid.org/0000-0002-0566-9833)
- Mary‐Claire Roghmann (ORCID: https://orcid.org/0000-0003-1063-9257)
- Nadim G. El Chakhtoura
- Sarah L. Krein (ORCID: https://orcid.org/0000-0003-2111-8131)
- Robin Jump (ORCID: https://orcid.org/0000-0001-5601-8996)
- Jessica Thiel (ORCID: https://orcid.org/0009-0005-7143-9023)
- Jennifer Ridenour
- Marco Cassone
- Lillian Min (ORCID: https://orcid.org/0000-0002-4149-5092)
- Alexandria Nguyen
- Evan S. Snitkin (ORCID: https://orcid.org/0000-0001-8409-278X)
- Taissa Bej (ORCID: https://orcid.org/0000-0002-4797-1432)
- Oteshia Hicks
- Kristen Gibson (ORCID: https://orcid.org/0000-0002-5648-5209)
- Andrzej T. Gałecki (ORCID: https://orcid.org/0000-0003-1542-4001)
- T. Clement
- Laxmi Chigurupati
Institutions
- University of Maryland, Baltimore (US)
- University of Pittsburgh (US)
- University of Michigan (US)
- John D. Dingell VA Medical Center (US)
- VA Ann Arbor Healthcare System (US)
- Geriatric Research Education and Clinical Center (US)
- Michigan Medicine (US)
- VA Center for Clinical Management Research (US)
- VA Northeast Ohio Healthcare System (US)
- VA Pittsburgh Healthcare System (US)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-03-13
- DOI
- https://doi.org/10.1038/s41467-025-57566-3
- Citations
- 3
- Primary Topic
- Infection Control in Healthcare
- Type
- article
- Field-Weighted Citation Impact
- 4.19