Study: Nursing homes should prioritize decolonization to reduce presence of multidrug-resistant organisms

News brief
Topics
Antimicrobial Stewardship
Healthcare-Associated Infections
Nursing home attendant in blue scrubs pushing female resident in wheelchair
sasirin pamai / iStock

A study conducted in two Southern California nursing homes found that only universal decolonization of residents was associated with reduced carriage of multidrug-resistant organisms (MDROs) and bedroom contamination, with daily enhanced cleaning providing no added benefit, researchers reported yesterday in JAMA Network Open.

MDROs are endemic in nursing homes, with studies showing more than 50% of residents carry MDROs on their skin. Using chlorhexidine wipes and nasal products to decolonize the skin of nursing home residents has been proven to substantially reduce MDRO carriage and subsequent infections, hospitalizations, and deaths. Other strategies, like enhanced environmental cleaning, have demonstrated reductions in MDRO contamination of hard surfaces. 

But implementing multiple strategies for reducing MDROs in nursing homes is expensive and resource intensive, note researchers with the University of California Irvine School of Medicine. "Thus, it is necessary to prioritize the most effective strategies," they wrote.

To assess the comparative benefits of the two strategies, the researchers conducted a four-phase quality-improvement study at two nursing homes. The four phases, implemented sequentially, included universal decolonization only, routine care (control), once-daily enhanced cleaning only, and universal decolonization plus enhanced cleaning. The primary outcomes were MDRO carriage on resident skin and in nostrils and MDRO contamination of high-touch objects in bedrooms and common areas.

Decolonization, disinfection of shared spaces

In adjusted models, decolonization alone was associated with 59% reduction in MDRO carriage compared with the control phase and a 64% reduction compared with enhanced cleaning. Enhanced cleaning alone did not reduce MDRO carriage and provided no additional benefit when combined with decolonization. 

The results were similar for bedroom contamination: Decolonization alone reduced bedroom contamination by 84% compared with the control phase and by 74% compared with enhanced cleaning, while enhanced cleaning alone did not reduce contamination and provided no benefit when combined with decolonization. 

In common areas, however, the combined intervention reduced contamination better than either intervention alone.

"Taken together, these findings suggest that resource-constrained settings should prioritize decolonization strategies, alongside targeted postactivity disinfection in shared spaces, for effective MDRO prevention," the authors concluded.

CDC and FDA: Salmonella outbreak linked to jalapenos expands to 27 states

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Topics
Salmonella
jalapeños
quazeck/Flickr cc

Today, both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) published food safety alerts about a growing Salmonella outbreak linked to jalapenos served at Chipotle and Qdoba restaurants across the country. 

So far, cases have been reported in 27 states, sickening at least 345 people. A total of 36 people have been hospitalized, but no deaths have been reported. Colorado and Minnesota have reported 110 cases each, with Illinois reporting 30 cases. 

“Of the 191 people interviewed, 177 (93%) reported eating at a Mexican-style restaurant before their illness, including Chipotle Mexican Grill and QDOBA, with meal dates ranging from June 14, 2026, to July 14, 2026,” the CDC said. 

The FDA said the jalapenos were from Sinaloa, Mexico, and distributed to restaurants by Coast Citrus Distributors. The distributer has recalled the peppers, and both Qdoba and Chipotle have stopped serving them.

“The CDC and FDA do not consider there to be a current ongoing risk from these establishments to consumers in this outbreak,” the CDC said. 

Senate panel votes to hold Fauci in contempt

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Topics
Public Health
COVID-19
Fauci speaking
Tony Fauci, MD, former NIAID director
CSIS / Flickr cc

The Senate Homeland Security Committee voted today to hold Anthony Fauci, MD, in contempt of Congress for his refusal last week to answer questions during a hearing on the COVID-19 pandemic. The vote fell along party lines, with Republicans leading the charge against the nation’s top pandemic-era scientist.

Republican lawmakers led by Sen. Rand Paul (R-KY), accuse Fauci of funding the Chinese research that allegedly leaked SARS-CoV-2 and caused the COVID-19 pandemic, then repeatedly lying to both Congress and the public about the origins and risks of the virus.

Possible federal misdemeanor charge 

During the hearing last week, the former National Institute of Allergy and Infectious Diseases director pled the Fifth Amendment more than 100 times instead of answering questions about the origins of SARS-CoV-2.

Today’s vote charges Fauci with failure to comply with a congressional subpoena when choosing to plead the Fifth, a federal misdemeanor. If found guilty, Fauci could see a prison sentence of up to 12 months. Now, the Department of Justice will investigate whether Fauci was exercising his constitutional rights during that hearing. 

“Today’s partisan committee vote is a crude political stunt intended to punish Dr. Fauci for exercising his constitutional rights,” said David Schertler, Fauci’s attorney, in a statement. “The Senate should reject Senator Paul’s meritless and politically-motivated contempt resolution. For years, Senator Paul has proclaimed to anyone who would listen that Dr. Fauci should be prosecuted and put in prison. Dr. Fauci has committed no crime—and Senator Paul knows it.”

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