Multicomponent Intervention Reduces Microbial Contamination in Nursing Homes

A comprehensive multicomponent intervention reduced the prevalence of multidrug-resistant organisms in patient rooms in nursing homes, according to a study published online in JAMA Network Open.

“To our knowledge, this is one of the first studies to show that multicomponent interventions can reduce environmental contamination in nursing homes,” wrote researchers from the University of Michigan Medical School in Ann Arbor.

The cluster randomized clinical trial was conducted in six Michigan nursing homes: three adopted the multicomponent intervention and three continued their standard care practices without the intervention. The study intervention included enhanced barrier precautions, chlorhexidine bathing, microbial surveillance, environmental cleaning education and feedback, hand hygiene promotion, and health care worker engagement.

Study visits, which included clinical data collection and multidrug-resistant organism surveillance culturing of several patient body sites and high-touch surfaces in patient rooms, occurred at baseline and on days 7, 14, 21, and 30, and then monthly for up to 6 months. The study included a total 245 patients, most of whom were receiving postacute care during shorter stays.

According to the study, the multicomponent intervention cut the odds of multidrug-resistant organism prevalence in the patient environment by 43%. Joint analysis of patient-environment dyads suggested the intervention significantly reduced the odds of overall multidrug-resistant organism prevalence in patients and their room environments, researchers reported.

“Our findings,” they concluded, “highlight the potential for multicomponent interventions to directly and indirectly reduce multidrug-resistant organism prevalence in nursing homes.”

Reference:
Mody L, Gontjes KJ, Cassone M, et al. Effectiveness of a Multicomponent Intervention to Reduce Multidrug-Resistant Organisms in Nursing Homes: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2021;4(7):e2116555. Published 2021 Jul 1. doi:10.1001/jamanetworkopen.2021.16555