More US nursing homes using antibiotic stewardship elements
An analysis of US nursing home surveys shows substantial progress in antibiotic stewardship element implementation, researchers with the Centers for Disease Control and Prevention (CDC) reported today in Infection Control & Hospital Epidemiology.
Looking at 7,506 National Healthcare Safety Network (NHSN) Long-Term Care Facility Component annual surveys conducted from 2016 through 2018, the researchers found that 1,323 nursing homes (71% of those enrolled in NHSN) reported implementing all seven of the CDC's core elements of antibiotic stewardship in 2018, a 28% increase from 2016.
Among the core elements, the greatest increases in implementation were in education of staff, residents, and families ( 19%); reporting information on antibiotic use (18%), and access to drug expertise (15%)—all of which had the lowest reported implementation in 2016. Pharmacist involvement in improving antibiotic use increased by 27% since 2016.
A multivariable analysis found that nursing homes that reported at least 20 hours of infection prevention control activity per week were 14% more likely to implement all seven core elements, when controlling for facility ownership and affiliation.
The study authors say the increase in implementation of the core elements was likely driven by antibiotic stewardship requirement imposed by the Centers for Medicare & Medicaid Services in November 2017 but may also reflect greater awareness and additional resources.
"Further research should evaluate the barriers facing nursing homes in implementing successful antibiotic stewardship policies and should identify the stewardship activities that are most feasible, sustainable, and effective in improving prescribing practices and resident outcomes in nursing home settings," they wrote.
May 26 Infect Control Hosp Epidemiol abstract
Minnesota confirms more deer farm CWD, with more farms quarantined
The Minnesota Board of Animal Health (BAH) confirmed the presence of chronic wasting disease (CWD) in 12 deer and discovered illegal carcass disposal at a deer farm in Beltrami County, leading to more farm quarantines across the state.
MBAH first detected CWD on that farm in April, and earlier this month, 54 animals in the herd were depopulated and samples from each animal were collected and then tested at the National Veterinary Services Laboratories.
"Of the 12 additional CWD positive animals most recently identified, nine were born on the Beltrami County farm and three were moved to the farm from other Minnesota herds. These herds are considered to be CWD exposed since there is a possibility the animals could have been infected with the disease prior to being moved to Beltrami County," BAH said in a press release.
A BAH agent discovered that several deer carcasses, including dead fawns, had been moved by the owner to nearby county land.
The Minnesota Department of Natural Resources (DNR) also released a statement emphasizing the seriousness of the situation, and said the situation at the Beltrami County deer farm "significantly changes the risk assessment and concern about CWD in Minnesota."
"Based on the findings in Beltrami County, last week BAH quarantined five additional farmed deer herds because of possible CWD exposure," the DNR said. "These additional herds are located in the following Minnesota counties: Hennepin, Kanabec, Mille Lacs, Morrison, and Mower."
CWD is a fatal neurologic prion disease that affects cervids such as deer, moose, and elk.
May 25 Minnesota BAH news release
May 25 Minnesota DNR statement
CIDRAP News scans from Apr 8 and May 19 on earlier detections