1539. Statewide survey of long-term care facilities practices regarding management of multidrug-resistant organisms
Session: Poster Abstract Session: Infections in Non-Acute Healthcare Settings
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C

Background:

Long-term care facilities (LTCFs) face significant challenges in controlling multidrug-resistant organisms (MDROs) due to limited resources and the complex medical needs of their residents. However, little is known regarding infection prevention and control practices, resources and capacity for surveillance in LTCFs.

Methods:

We surveyed administrators and directors of nursing of 140 Oregon LTCFs using a 27-question, self-administered questionnaire. Only one respondent per facility completed the survey. Questions focused on infection control policies and procedures; laboratory capacity and reporting; and MDRO management.

Results:

Approximately 42% (59/140) of facilities responded to thesurvey. Median daily census of responding facilities was 48 residents (IQR=38, 68). Median staff time per week devoted to infection prevention and control was 5 hours (IQR=3, 8.6).

Responses to questions on practices implemented for patients known to be infected or colonized with MDROs are displayed in the table.

Implemented for active infection

N (%)

Implemented for colonization

N (%)

Private room

42 (71)

16 (27)

Contact precautions

56 (95)

31 (52)

Dedicated equipment

52 (88)

19 (32)

Follow-up testing for MDRO status

47 (81)

26 (44)

Less than half of respondents (48%) were aware of the emergence of carbapenem-resistant Enterobacteriaceae (CRE); none had encountered a CRE-positive patient. Nearly 58% cited catheter-associated urinary tract infection as the most difficult infection to prevent and 14% stated they had no current infection prevention difficulties.

Nearly 80% of respondents stated that their transfer documents indicated MDRO infection or colonization status upon release to other levels of care and 75% said MDRO status was documented for residents transferred into their facility.

Conclusion:

Limited resources and training for infection control in Oregon LTCFs present challenges for reducing MDRO transmission. Discrepant infection control practices for colonized and infected residents suggest a need for education on the role of colonized patients in the dissemination of MDRO. More work is needed to improve communication among healthcare facilities during transitions of care.

Margaret Cunningham, MPH1, Jon Furuno, PhD2, Christopher Pfeiffer, MD3, Tasha Poissant, MPH1, Ann Thomas, MD, MPH1 and Zintars G. Beldavs, MS1, (1)Oregon Health Authority, Portland, OR, (2)Oregon State University College of Pharmacy, Portland, OR, (3)Portland VA Medical Center, Portland, OR

Disclosures:

M. Cunningham, None

J. Furuno, None

C. Pfeiffer, None

T. Poissant, None

A. Thomas, None

Z. G. Beldavs, None

Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.