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Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States

Author

Listed:
  • Lona Mody

    (University of Michigan Medical School
    Veterans’ Affairs Ann Arbor Healthcare System)

  • Kristen E. Gibson

    (University of Michigan Medical School)

  • Marco Cassone

    (University of Michigan Medical School)

  • Ganga Vijayasiri

    (University of Michigan Medical School)

  • Tasmine Clement

    (University of Michigan)

  • Evan Snitkin

    (University of Michigan Medical School)

  • Sanjay Saint

    (University of Michigan Medical School
    Department of Veterans’ Affairs Center for Clinical Management Research)

  • Sarah L. Krein

    (University of Michigan Medical School
    Department of Veterans’ Affairs Center for Clinical Management Research)

  • Mary R. Janevic

    (University of Michigan School of Public Health)

  • Jessica Thiel

    (Veterans’ Affairs Ann Arbor Healthcare System)

  • Jennifer Ridenour

    (Veterans’ Affairs Ann Arbor Healthcare System)

  • Alexandria Nguyen

    (VA Northeast Ohio Healthcare System)

  • Oteshia Hicks

    (VA Northeast Ohio Healthcare System)

  • Taissa A. Bej

    (VA Northeast Ohio Healthcare System)

  • Nadim G. El Chakhtoura

    (VA Northeast Ohio Healthcare System)

  • Lillian Min

    (University of Michigan Medical School
    Veterans’ Affairs Ann Arbor Healthcare System)

  • Andrzej Galecki

    (University of Michigan Medical School
    University of Michigan School of Public Health)

  • Todd Greene

    (University of Michigan Medical School
    Veterans’ Affairs Ann Arbor Healthcare System)

  • Mary-Claire Roghmann

    (University of Maryland School of Medicine
    Veterans Affairs Maryland Health Care System)

  • Laxmi Chigurupati

    (John D. Dingell Department of Veterans Affairs Medical Center)

  • Federico Perez

    (VA Northeast Ohio Healthcare System)

  • Robin L. P. Jump

    (VA Pittsburgh Healthcare System
    University of Pittsburgh School of Medicine)

Abstract

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.

Suggested Citation

  • Lona Mody & Kristen E. Gibson & Marco Cassone & Ganga Vijayasiri & Tasmine Clement & Evan Snitkin & Sanjay Saint & Sarah L. Krein & Mary R. Janevic & Jessica Thiel & Jennifer Ridenour & Alexandria Ngu, 2025. "Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States," Nature Communications, Nature, vol. 16(1), pages 1-16, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57566-3
    DOI: 10.1038/s41467-025-57566-3
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