Antibiograms Cannot Be Used Interchangeably Between Acute Care Medical Centers and Affiliated Nursing Homes.
Maria-Stephanie A Hughes, David M Dosa, Aisling R Caffrey and 4 others
PMID 31537479WHAT IT FOUND
Antibiograms from affiliated acute care hospitals cannot be used interchangeably with those from nursing homes.
None of the 119 paired facilities showed complete agreement on which antibiotics would work, with an average of 20% of bacteria-antibiotic comparisons disagreeing.
Key findings
01None of the 119 nursing home and affiliated hospital pairs had complete agreement in their antibiograms.
02On average, 20% of bacteria-antibiotic comparisons disagreed clinically between the nursing home and the affiliated hospital.
03Disagreement was more often due to the nursing home having lower susceptibility than the hospital, occurring in 13% of comparisons versus 7% in the opposite direction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study focused exclusively on the Veterans Affairs system, which is a closed health care network and may not reflect the general population. Many nursing homes had low numbers of cultures for certain organisms, which can make susceptibility estimates less accurate. The analysis used a fixed 80% susceptibility cutoff, whereas clinicians may use different thresholds in practice. Some nursing homes and hospitals shared the same geographic campus, yet disagreement was still common, suggesting the issue is not just distance but distinct patient populations.
The easy way to misread this
Do not assume that geographic proximity or shared affiliation guarantees similar antibiotic resistance patterns. Even when a nursing home is on the same campus as an acute care hospital, their antibiograms disagreed in 20% of comparisons on average, meaning hospital data is not a safe substitute for local nursing home data.