title: Challenges and Strategies for Prevention of Multidrug-Resistant Organism Transmission in Nursing Homes.
abstract: OBJECTIVE
  Nursing home residents are at high risk for colonization and infection with bacterial pathogens that are multidrug-resistant organisms (MDROs). We discuss challenges and potential solutions to support implementing effective infection prevention and control practices in nursing homes.
  
  
  RESULTS
  Challenges include a paucity of evidence that addresses MDRO transmission during the care of nursing home residents, limited staff resources in nursing homes, insufficient infection prevention education in nursing homes, and perceptions by nursing home staff that isolation and contact precautions negatively influence the well being of their residents. A small number of studies provide evidence that specifically address these challenges. Their outcomes support a paradigm shift that moves infection prevention and control practices away from a pathogen-specific approach and toward one that focuses on resident risk factors.
authors.affiliation: Infectious Diseases Division and Center for Community Health, University of Rochester, 46 Prince St, Rochester, NY, 14607, USA. ghinwa_dumyati@urmc.rochester.edu.
authors.forename: Ghinwa
authors.initials: G
authors.lastname: Dumyati
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA.
authors.forename: Nimalie D
authors.initials: ND
authors.lastname: Stone
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, 3471 Fifth Ave, Kaufman Medical Building, Suite 500, Pittsburgh, PA, 15213, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Nace
authors.affiliation: University of Wisconsin, Madison, WI. Geriatric Research Education and Clinical Center (GRECC), William Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.|Case Western Reserve University, Cleveland, Ohio. GRECC, Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Crnich
authors.affiliation: University of Wisconsin, Madison, WI. Geriatric Research Education and Clinical Center (GRECC), William Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.|Case Western Reserve University, Cleveland, Ohio. GRECC, Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
authors.forename: Robin L P
authors.initials: RL
authors.lastname: Jump
keywords: Clostridium difficile; Infection prevention and control; Methicillin-resistant Staphylococcus aureus; Multidrug-resistant organisms; Nursing home