Nursing home study: Resident decolonization more effective against drug-resistant bacteria

A study conducted at two Southern California nursing homes indicates that resident decolonization is more effective at reducing drug-resistant bacteria than enhanced environmental cleaning. The research, published in JAMA Network Open, utilized a four-phase quality-improvement design between March 2019 and April 2021 to compare different infection control strategies.

Findings showed that universal decolonization—using chlorhexidine for bathing and a nasal antiseptic like povidone-iodine—reduced the carriage of multidrug-resistant organisms on residents' skin by 59% and in their nostrils compared to routine care. It also reduced contamination of high-touch objects in bedrooms by 84%.

In contrast, increasing daily environmental cleaning of rooms did not reduce bacterial carriage. Furthermore, combining enhanced cleaning with decolonization provided no additional measurable benefit for skin or bedroom contamination. The study suggests these findings may assist long-term care facilities in prioritizing limited infection control budgets toward resident-level interventions.