Hierarchical multilevel prospective study of multidrug-resistant organisms: Decolonization, mortality, and co-colonization in a long-term care facility

The hierarchical analysis showed that, contrary to common expectations, decolonization was independent of patient attributes (age and sex) and that, in this LTCF setting, mortality was unrelated to pathogen identity. Asymmetric co-colonization therefore warrants automatic CRE screening following MRAB, MRPA, or VRE isolation, and underscores the need to investigate directional co-colonization patterns among multiple MDRO co-colonizations commonly observed in LTCFs-as exemplified by vanA transfer from VRE to MRSA (methicillin-resistant Staphylococcus aureus) yielding VRSA (vancomycin-resistant Staphylococcus aureus).