The Risk of Drug-Resistant Infections at Nursing Homes
A recent article in the Wall Street Journal (WSJ) cited research by the Columbia University School of Nursing indicating that residents of long-term care facilities are vulnerable to drug-resistant infections known as superbugs, which can then easily spread these deadly germs to others. In fact, according to the research, between 11% and 59% of nursing-home residents have been “colonized” with certain types of superbugs, putting them at more risk of developing a full-blown infection. A person is colonized when a germ is on the skin or in the body – for example, in the nose. Although not yet infected, the person can spread the bug.
This danger of superbugs has been a focus in hospitals by government regulators and the public for years, but this risk in nursing homes up until now hasn’t received the same type of attention. According to the Columbia research cited in the WSJ, nursing home residents are “especially susceptible” to these infections because of their age, tenuous immune systems and many ailments.
“You have a fragile group of individuals. They are older, they are sick and they are living in nursing homes,” Dr. Arlene Smaldone, assistant dean at Columbia said, noting that bacteria can enter through a break in the skin and develop into an infection. E. Coli is an example of a superbug, which can be deadly and includes strains that have become resistant to antibiotics.
The research team, headed by Sainfer Aliyu, an emergency-room-nurse-turned-Columbia Ph.D. candidate, reviewed 327 articles about nursing-home infections before focusing on eight to form the basis of the team’s statistical analysis. Their conclusion: 27% of nursing-home residents were “colonized” with certain superbugs. “”If you are colonized, the likelihood you will get a drug-resistant infection will be much higher,” said Dr. Theresa Madaline, a clinical director of Infectious Disease Services at Montefiore Health System in Bronx, N.Y.
LeadingAge, a trade association whose members include non-profit nursing homes, in response to the Columbia research, stated that “the vast majority of people colonized are never infected” with superbugs. While one-quarter of nursing-home residents may be carrying certain germs, “we are not seeing 25% of people infected” with drug-resistant organisms, said Dr. Cheryl Phillips, an official at LeadingAge and geriatrician.
Overuse of antibiotics – in nursing homes and society overall – is at the heart of the problem, according to Dr. Phillips. She supports new policies by the Centers for Medicare and Medicaid Services that require nursing homes to have stronger antibiotics controls.
Infections have been a problem in nursing homes but how many infections involve drug-resistant organisms isn’t clear. The Centers for Disease Control and Prevention (CDC) about ten years ago created a system to track infections in hospitals. Now called the National Healthcare Safety Network, it also monitors superbugs. More recently, the CDC added an option for nursing homes to report and monitor cases. Out of about 15,700 nursing homes in the U.S., about 2,500 – or about 16% of nursing homes – have signed up, according to a Columbia Nursing School analysis. Part of the reason for the low participation, according to LeadingAge’s Dr. Phillips, is the fact that some nursing homes are small and don’t have the resources to be part of the tracking system. Meanwhile, the CDC is working to get nursing homes to embrace some reporting measures and more rigorous infection control.
Caitlin Morgan specializes in providing insurance for nursing homes. We are committed to bringing issues and exposures that affect the industry to the forefront. For information about our portfolio of insurance products for nursing homes, assisted living facilities and the senior living industry at large, contact us at 877.226.1027.
Source: Wall Street Journal