As COVID-19 took hold over the last year, nursing homes used and reused protective equipment, masks, gloves, gowns, etc. to assist in preventing the spread of the virus. Bring on opportunistic, drug-resistant bacteria and fungi! These bacteria and fungi, like COVID-19, prey on older people, those with compromised immune systems. These bacteria and fungi can cling tenaciously to clothing and medical equipment, which is why nursing homes and hospitals before the pandemic were increasingly focused on cleaning rooms and changing gowns to prevent their spread.

Dr. Susan S. Huang, an infectious disease specialist at the University of California at Irvine Medical School said:  “seeing the world as one-pathogen world is really problematic, we have every reason to believe the problem has gotten worse”. Experts have said that they are not suggesting that the priority on fighting COVID-1 was misplaced but rather they say that renewed attention must be paid to drug-resistant germs. Research has shown that as many as 65% of residents of nursing homes carry some form of a drug-resistant infection.

There are many possible reasons for the uptick in drug-resistant bacteria/fungi including increased use of ventilators on the frail elderly and the heavy use of steroids to treat COVID-19. Remember, steroids can leave the immune system compromised in a way that allows other germs to more easily infiltrate the body. Talk to your medical director and laboratory provider to determine if your center is experiencing an uptick in these opportunistic infections. If so, work through your QAPI committee to identify the root cause and implement corrective actions to turn the numbers around. Don’t forget to initiate a history of past non-compliance if you are a skilled building! Stay the course, stay well, mask up, get vaccinated, and stay tuned!