# Epidemiology of MDRO Carriage in Nursing Homes

> **NIH NIH P01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2023 · $1,327,053

## Abstract

Abstract
Project 1: Epidemiology of MDRO Carriage and Adverse Health Outcomes in Nursing Homes
 Multidrug-resistant organisms (MDROs) are serious and urgent threats to human health. Although
extensive efforts have begun to reverse the tide in hospitals, investments are severely lacking in nursing
homes (NHs) where MDRO prevalence is much greater (routinely 65% vs. 10% in hospitals). NHs are unique
settings that may be particularly prone to spreading contagion due to their long lengths-of-stay, care of
medically vulnerable residents, encouragement of shared spaces and activities, high staff turnover, and limited
infection prevention training. Due to scarce resources for screening, surveillance, and strategies to combat
MDROs, evidence is needed to create guidelines for MDRO reduction strategies specific to NHs.
 This project will encompass an in-depth and simultaneous assessment of five major MDROs of clinical
significance to the 1.4 million people who are cared for in 15,000 U.S. nursing homes each year. These
MDROs include three endemic pathogens that are entrenched in NHs, namely methicillin-resistant
Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and extended-spectrum beta-
lactamase producers (ESBLs), as well as two emerging MDROs– carbapenem-resistant Enterobacterales
(CRE), and Candida auris, an antibiotic-resistant fungus capable of substantial morbidity and mortality. The
goal of the simultaneous assessment of these MDROs is to assess synergistic capture from screening cultures
and inform interventions that would target MDROs in concert.
 We will capitalize on the combination of retrospective and prospective studies involving over 10,000 NH
residents from 50 NHs to evaluate efficient ways to sample body sites and environmental objects for MDRO
carriage and co-carriage. We also will perform comprehensive assessments of resident, NH, and community-
level risk factors for carriage of MDROs, alone and in combination. Beyond carriage, we will use these data to
assess risk factors for later MDRO infection and hospitalization. Importantly, we will specifically evaluate
whether risk factors are differentially affected by race, ethnicity, and socioeconomic status to better elucidate
NH disparities in care delivery or health outcomes. Knowledge of major drivers of carriage and infection will
inform the need and value of NH interventions to transform policy and practice.

## Key facts

- **NIH application ID:** 10549490
- **Project number:** 1P01AI172725-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** Susan S. Huang
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,327,053
- **Award type:** 1
- **Project period:** 2023-07-11 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10549490

## Citation

> US National Institutes of Health, RePORTER application 10549490, Epidemiology of MDRO Carriage in Nursing Homes (1P01AI172725-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10549490. Licensed CC0.

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