Infection prevention and antimicrobial stewardship (AMS) in aged care-United States perspective

Professor Patricia Stone

Across the United States there are over 1 million elderly persons living in the 15,700 nursing homes on any given day. These vulnerable residents are particularly susceptible to infections due to multiple reasons. A cross-sectional survey of 990 NHs was conducted and linked to a national data base that contains information about the facility as well as infection control deficiency citations given by the Centers for Medicare & Medicaid Services (CMS) on annual inspections.  One third of NH received an infection control deficiency citation. Weekly/monthly and quarterly infection control committee meetings were held in 61% and 27% of NH, respectively. Staff turnover was high. NH that received deficiency citations were more likely to have infection control committees that met weekly/monthly versus quarterly (p < 0.01).  Infection preventionist (IPs) in 39% of facilities had received specialized training. NHs with trained IPs were more likely to have 5 of the 7 components of antibiotic stewardship in place (all p values < 0.05). With new CMS regulations taking effect in 2016, more research is warranted.