ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
The SHIELD Orange County Project: Multidrug-resistant Organism Prevalence in 21 Nursing Homes and Long-term Acute Care Facilities in Southern California.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed.
- Decolonization in Nursing Homes to Prevent Infection and Hospitalization.The New England journal of medicine · 2023Trial
- Decolonization vs Enhanced Cleaning for Multidrug-Resistant Organism Reduction in Nursing Homes.JAMA network open · 2026Article
- Multidrug-resistant organism (MDRO) contamination of nursing home staff hands and forearms when entering the breakroom or going home.Infection control and hospital epidemiology · 2026Article
- Colonization with multidrug-resistant organisms (MDROs) includingInfection control and hospital epidemiology · 2026Article
- A Public Health Approach to Antimicrobial Stewardship in Long-term Care Facilities: A Multifaceted Program in Massachusetts.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Surveillance for Candida auris - United States, 2022-2024.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2026Article
- Environmental contamination and cleaning practices in long-term care: a transdisciplinary mixed-methods study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Improving containment and prevention strategies using a patient transfer network representative of patients with multidrug-resistant organisms.Infection control and hospital epidemiology · 2025Article
- Rising Threats of MRSA and Carbapenem-ResistantMicroorganisms · 2025Article
- Progression from Candida auris Colonization Screening to Clinical Case Status, United States, 2016-2023.Emerging infectious diseases · 2025Article
- Prevalence and risk factors for carriage of carbapenem-resistantEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Characteristics of nursing homes with high rates of invasive methicillin-resistant Staphylococcus aureus infections.Journal of the American Geriatrics Society · 2025Article
- Healthcare as a driver, reservoir and amplifier of antimicrobial resistance: opportunities for interventions.Nature reviews. Microbiology · 2024Review
- Hand and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp.Antimicrobial resistance and infection control · 2024Review
- Expanding the use of mathematical modeling in healthcare epidemiology and infection prevention and control.Infection control and hospital epidemiology · 2024Review
- A multi-center validation of the electronic health record admission source and discharge location fields against the clinical notes for identifying inpatients with long-term care facility exposure.Infection control and hospital epidemiology · 2024Article
- Molecular and Epidemiological Investigation of Fluconazole-resistantOpen forum infectious diseases · 2024Article
- Rapid Environmental Contamination With Candida auris and Multidrug-Resistant Bacterial Pathogens Near Colonized Patients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Not as simple as it seems: extensive facility and training gaps in nursing home bathing.Infection control and hospital epidemiology · 2023Article
- Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites.Microbiology spectrum · 2023Article
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Authors and funding
39 authors.
Funding
Abstract
backgroundMultidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NHs), and long-term acute care facilities (LTACs) via patient transfers. The Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County is a regional public health collaborative involving decolonization at 38 healthcare facilities selected based on their high degree of patient sharing. We report baseline MDRO prevalence in 21 NHs/LTACs.
methodsA random sample of 50 adults for 21 NHs/LTACs (18 NHs, 3 LTACs) were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum β-lactamase-producing organisms (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE) using nares, skin (axilla/groin), and peri-rectal swabs. Facility and resident characteristics associated with MDRO carriage were assessed using multivariable models clustering by person and facility.
resultsPrevalence of MDROs was 65% in NHs and 80% in LTACs. The most common MDROs in NHs were MRSA (42%) and ESBL (34%); in LTACs they were VRE (55%) and ESBL (38%). CRE prevalence was higher in facilities that manage ventilated LTAC patients and NH residents (8% vs <1%, P < .001). MDRO status was known for 18% of NH residents and 49% of LTAC patients. MDRO-colonized adults commonly harbored additional MDROs (54% MDRO+ NH residents and 62% MDRO+ LTACs patients). History of MRSA (odds ratio [OR] = 1.7; confidence interval [CI]: 1.2, 2.4; P = .004), VRE (OR = 2.1; CI: 1.2, 3.8; P = .01), ESBL (OR = 1.6; CI: 1.1, 2.3; P = .03), and diabetes (OR = 1.3; CI: 1.0, 1.7; P = .03) were associated with any MDRO carriage.
conclusionsThe majority of NH residents and LTAC patients harbor MDROs. MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NHs/LTACs as part of regional efforts to control MDRO spread.
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