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Regional decolonization aids multidrug-resistant organism-related outcomes
A regional collaborative involving universal decolonization in long-term care facilities and targeted decolonization among hospital patients in contact precautions is associated with better multidrug-resistant organism (MDRO)-related outcomes, according to a study published online April 1 in the Journal of the American Medical Association.
Gabrielle M. Gussin, from the University of California Irvine School of Medicine, and colleagues evaluated whether implementation of a decolonization collaborative is associated with reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalizations, costs, and deaths. The analysis included data from 35 participating facilities (16 hospitals, 16 nursing homes [NHs], and three long-term acute care hospitals [LTACHs]).
The researchers found that compared with baseline, decolonization was associated with a decrease in mean MDRO prevalence (NHs: 63.9 to 49.9%; LTACHs: 80.0 to 53.3%; odds ratio for both, 0.48; hospitalized patients in contact precautions: 64.1 to 55.4%; odds ratio, 0.75). Mean monthly incident MDRO clinical cultures changed from 2.7 to 1.7 among participating NHs, from 1.7 to 1.5 among nonparticipating NHs (group × period interaction reduction, 30.4%), and from 25.5 to 25.0 among participating hospitals and 12.5 to 14.3 among nonparticipating hospitals (group × period interaction reduction, 12.9%). Benefits were seen for infection-related hospitalizations, associated hospitalization costs, and associated hospitalization deaths.
"The success of SHIELD-OC [Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County] in reducing MDRO carriage, infections, hospitalizations, and associated costs and deaths led to a regional NH incentive program supported by CalOptima, the sole Medicaid provider," the authors write.
Antiseptic supplies for the study were provided by Stryker (Sage Products), Xttrium Laboratories, and Medline Industries.
More information: Gabrielle M. Gussin et al, Reducing Hospitalizations and Multidrug-Resistant Organisms via Regional Decolonization in Hospitals and Nursing Homes, JAMA (2024). DOI: 10.1001/jama.2024.2759
Christopher J. Crnich, Controlling Multidrug-Resistant Organisms Across Patient-Sharing Networks, JAMA (2024). DOI: 10.1001/jama.2024.0267
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