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Correlations between quality ratings of skilled nursing facilities and multidrug-resistant urinary tract infections

      Highlights

      • Risk factors associated with urinary tract infections caused by multidrug-resistant organisms in skilled nursing facilities were investigated.
      • The mean predicted probability of urinary tract infections and improper collection of specimens was inversely dependent on the facility's overall star rating.
      • The presence of multidrug-resistant organisms highly correlated with the type of nursing care received.

      Background

      The purpose of this study was to determine risk factors for the acquisition of urinary tract infections (UTIs) and multidrug-resistant organisms (MDROs) in residents of skilled nursing facilities (SNFs).

      Methods

      Using the informational database provided by the Centers for Medicare and Medicaid Services (CMS), a retrospective logistic regression was performed on 1,523 urine cultures from 12 SNFs located in Long Island, New York.

      Results

      Of the 1,142 positive urine cultures, Escherichia coli was most prevalent. Additionally, 164 (14.4%) of the UTIs were attributed to an MDRO. In multivariate logistic regression, sex and overall quality rating predicted the occurrence of UTIs, whereas identification of MDROs was dependent on the level of nursing care received. The mean predicted probability of UTIs and receipt of contaminated samples was inversely dependent on the facility's rating, where the likelihood increased as overall quality ratings decreased.

      Conclusions

      The CMS's quality rating system may provide some insight into the status of infection control practices in SNFs. The results of this study suggest that potential consumers should focus on the overall star ratings and the competency of the nursing staff in these facilities rather than on individual quality measures.

      Key Words

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