Epidemiology and transmission dynamics of multidrug-resistant organisms in nursing homes within the United States

Lona Mody (), Kristen E. Gibson, Marco Cassone, Ganga Vijayasiri, Tasmine Clement, Evan Snitkin, Sanjay Saint, Sarah L. Krein, Mary R. Janevic, Jessica Thiel, Jennifer Ridenour, Alexandria Nguyen, Oteshia Hicks, Taissa A. Bej, Nadim G. El Chakhtoura, Lillian Min, Andrzej Galecki, Todd Greene, Mary-Claire Roghmann, Laxmi Chigurupati, Federico Perez and Robin L. P. Jump
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Lona Mody: University of Michigan Medical School
Kristen E. Gibson: University of Michigan Medical School
Marco Cassone: University of Michigan Medical School
Ganga Vijayasiri: University of Michigan Medical School
Tasmine Clement: University of Michigan
Evan Snitkin: University of Michigan Medical School
Sanjay Saint: University of Michigan Medical School
Sarah L. Krein: University of Michigan Medical School
Mary R. Janevic: University of Michigan School of Public Health
Jessica Thiel: Veterans’ Affairs Ann Arbor Healthcare System
Jennifer Ridenour: Veterans’ Affairs Ann Arbor Healthcare System
Alexandria Nguyen: VA Northeast Ohio Healthcare System
Oteshia Hicks: VA Northeast Ohio Healthcare System
Taissa A. Bej: VA Northeast Ohio Healthcare System
Nadim G. El Chakhtoura: VA Northeast Ohio Healthcare System
Lillian Min: University of Michigan Medical School
Andrzej Galecki: University of Michigan Medical School
Todd Greene: University of Michigan Medical School
Mary-Claire Roghmann: University of Maryland School of Medicine
Laxmi Chigurupati: John D. Dingell Department of Veterans Affairs Medical Center
Federico Perez: VA Northeast Ohio Healthcare System
Robin L. P. Jump: VA Pittsburgh Healthcare System

Nature Communications, 2025, vol. 16, issue 1, 1-16

Abstract: Abstract Nursing home (NH) residents in the United States routinely attend interactive visits for services such as therapy or dialysis, creating opportunities for pathogen transmission. A paucity of studies exist which delineate spread of pathogens beyond residents’ in-room environment. In this prospective cohort study, we recruited 197 newly-admitted residents across three Veterans Affairs NHs to characterize multidrug-resistant organism (MDRO) prevalence, acquisition, and transmission. Participant hands, nares, groin, and seven environmental surfaces were swabbed during 758 regularly scheduled in-room visits; participant hands, healthcare personnel hands, and equipment were swabbed during 345 unscheduled interactive visits. We demonstrate that baseline MDRO colonization and new acquisition is common, and one in six interactive visits result in MDRO transmission. Whole genome sequencing on a subset of participants enabled us to identify sources of transmission where it was unknown using microbiologic methods alone. Our results illustrate MDRO transmission pathways and highlight the need for innovative, multidisciplinary interventions.

Date: 2025
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DOI: 10.1038/s41467-025-57566-3

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