title: Survey of long-term-care facilities in Iowa for policies and practices regarding residents with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci.
abstract: OBJECTIVE
  To identify infection control policies and practices used by long-term-care facilities (LTCFs) in Iowa for residents with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), and to estimate the prevalence of residents known to have these organisms.
  
  
  METHODS
  Survey.
  
  
  METHODS
  LTCFs in Iowa from December 2002 through March 2003.
  
  
  RESULTS
  Of the 429 LTCFs in Iowa, 331 (77%) responded to the survey. The estimated prevalence of residents known to have MRSA was 13.4 per 1,000 and that of residents known to have VRE was 2.3 per 1,000. Facilities owned by the government or those with an average of more than 86 occupied beds were more likely to have residents known to have MRSA and VRE (P = .002 and .007, respectively). Of the responding facilities, 7.3% acknowledged that they refused to accept individuals known to have MRSA and 16.9% acknowledged that they refused to accept those known to have VRE. Facilities in large communities (population, > 100,000) were least likely to deny admission to an individual known to have either MRSA or VRE (P = .05). Most facilities reported adhering to the national guidelines, but fewer than half (44.7%) of the respondents had heard of the Iowa Antibiotic Resistance Task Force's guidelines regarding residents with MRSA or VRE.
  
  
  CONCLUSIONS
  Many LTCFs in Iowa care for residents known to have MRSA or VRE, but some refuse to admit these individuals. Infection control personnel and public health officials should work together to educate LTCF staff so that residents receive proper care and resistant organisms do not spread within this setting.
authors.affiliation: Department of Epidemiology, University of lowa College of Public Health, Iowa City, IA 52242-1081, USA.
authors.forename: Trisha
authors.initials: T
authors.lastname: Kreman
authors.forename: Jianfang
authors.initials: J
authors.lastname: Hu
authors.forename: Jean
authors.initials: J
authors.lastname: Pottinger
authors.forename: Loreen A
authors.initials: LA
authors.lastname: Herwaldt
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D016983:Enterococcus / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007484:Iowa / Q000453:epidemiology; D008134:Long-Term Care; D016106:Methicillin Resistance; D009735:Nursing Homes / Q000458:organization & administration*; D016134:Organizational Policy; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D020713:Vancomycin Resistance