Investigating Universal Decolonization in Long-Term Care Facilities to Reduce Infection Risk
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on October 27th, 2023
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Residents of long-term care facilities are at a higher risk of infection due to their old age, and comorbidities. In addition, previous surveillance had shown that the prevalence of multidrug resistance organisms was 4 to 6 times higher in the nursing home setting than in hospital. Thus, a study was conducted to investigate the potential benefit of universal decolonization can reduce the risk of infection and need for hospitalization
In this cluster-randomized controlled trial involving 28 nursing homes and a total of 28,956 residents, the two groups were randomly selected to receive either standard care or universal decolonization. The average age in both groups was approximately 76 years old, and the prevalence of comorbidities such as diabetes, chronic pulmonary disorders, renal failure, liver disease, and cancer was similar between the two groups. In the standard care group, residents received regular bathing procedures, while those in the decolonization group followed a regimen that involved nasal decolonization using 10% povidone-iodine twice a day for five days every other week, along with bathing using 4% chlorhexidine. After an 18-month period, the researchers found that universal decolonization significantly reduced the risk of hospitalization due to infection by 16.6%. This approach also contributed to a 30% reduction in the prevalence of infections caused by multidrug-resistant organisms and methicillin-resistant Staphylococcus aureus. Importantly, the process of decolonization did not result in a significant number of adverse events, with only 34 cases of rashes and 1 incident of a sore throat reported in total.
In this cluster-randomized controlled trial involving 28 nursing homes and a total of 28,956 residents, the two groups were randomly selected to receive either standard care or universal decolonization. The average age in both groups was approximately 76 years old, and the prevalence of comorbidities such as diabetes, chronic pulmonary disorders, renal failure, liver disease, and cancer was similar between the two groups. In the standard care group, residents received regular bathing procedures, while those in the decolonization group followed a regimen that involved nasal decolonization using 10% povidone-iodine twice a day for five days every other week, along with bathing using 4% chlorhexidine. After an 18-month period, the researchers found that universal decolonization significantly reduced the risk of hospitalization due to infection by 16.6%. This approach also contributed to a 30% reduction in the prevalence of infections caused by multidrug-resistant organisms and methicillin-resistant Staphylococcus aureus. Importantly, the process of decolonization did not result in a significant number of adverse events, with only 34 cases of rashes and 1 incident of a sore throat reported in total.