There may be potential ways to reduce multi-drug resistant organisms (MDROs) on patients’ skin, but fully eliminating these super bugs within nursing homes remains a difficult task.

A recent study from researchers with the University of California Los Angeles Medical Center and the University of California Irvine School of Medicine may pose answers to cutting the bacterial load from MDROs on patients’ skin, but also showed how difficult complete eradication within a facility can be.

The results of the nine-month study were published in Infection Control & Hospital Epidemiology. The study, conducted in three nursing homes, consisted of three-month baseline, three-month phase-in and three-month intervention phases. The study examined skin colonization of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant Enterobacterales (CRE).

During the intervention phase, residents carrying bacterial colonies bathed regularly with chlorhexidine and used nasal iodophor. Researchers took regular skin and nasal swabs to test for continued colonization. The researchers also swabbed high-tough surfaces within residents’ rooms.

Overall resident MDRO prevalence fell from 46% (411 of 900 residents) to 29% (262 of 900), an overall decrease of 55%, with each individual pathogen seeing significant declines in prevalence.

Some residents retained pathogen colonies, the study said, and in 85% of those rooms, surface contamination with an MDRO remained. In a multivariable analysis, MDRO surface contamination in rooms of carriers was associated with antibiotic use, wound presence, and specific surfaces such as bedside table/bedrails.

“Although the exact reason for lack of MDRO environmental contamination reduction in rooms of residents with MDRO colonization during the decolonization period is difficult to determine, our result may suggest that those residents who failed MDRO decolonization may be more likely to shed their MDRO in the environment,” the study authors wrote.

The authors concluded that better surface disinfection may be the key to controlling the environmental spread of MDROs.