P-1104. Multidrug-Resistant Organism (MDRO)-Contaminated Mobile Equipment Networks in Skilled Nursing Facilities
Open Forum Infectious Diseases · 2026
Published2026
Abstract
Background: Multidrug-resistant organisms (MDROs) are prevalent in skilled nursing facilities (SNFs). Mobile equipment has been linked to outbreaks but its role in MDRO endemicity is less understood. Methods: We conducted 2 waves of 4-day microbiological sampling 3 to 6 months apart in 3 ventilator-capable SNFs (1 academic affiliate, 2 community-based). We collected patient room composite samples at shift start; up to 8 types of shared equipment were sampled at start and end of sampling day and after observed use. Samples were enriched and plated on selective media (for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, extended-spectrum β-lactamase producing Enterobacteriaceae, and multidrug-resistant Acinetobacter species). Presumptive MDRO positives were MALDI-confirmed. Wireless sensors in patient rooms and attached to shared equipment recorded equipment location and movement, allowing creation of bipartite networks (nodes: rooms and equipment). Two rooms were connected when the same equipment item visited both rooms. We used Exponential Family Random Graph Models to analyze network structure and test if: 1) a room was more likely to have an MDRO detected if connected by equipment to another room with the same MDRO and 2) MDRO detection frequency differed by facility. Results: 8 types of mobile equipment were studied but only glucometers were shared items at all facilities (Figure 1). Equipment degree (the number of different rooms an item visited during deployment) varied substantially (Figure 1). MDRO contamination depended on facility and equipment type (Figure 2). ESBLs and MRSA were the most common MDROs on room surfaces and mobile equipment. Contamination was low in facility A relative to other facilities (Table 1). Vital signs carts had a high median degree (12) but were rarely contaminated (6%, n=6). Shower beds also had high median degree (9) but were often contaminated (25%, n=13) in the two facilities that used them. Network analysis of facility B found that rooms connected by shared equipment were more likely to be contaminated by the same MDRO than unconnected rooms (p< 0.05). Conclusion: Shared equipment in SNFs moves between patient rooms and is often MDRO-contaminated. Future work should study the role of shared equipment in MDRO transmission.
Cite
@article{visnovskyMultidrugResistantOrganism2026,
title = {P-1104. Multidrug-Resistant Organism (MDRO)-Contaminated Mobile Equipment Networks in Skilled Nursing Facilities},
author = {{Visnovsky}, {Lindsay D.} and {Leecaster}, {Molly} and {Vega Yon}, {George G.} and {Loc-Carrillo}, {Catherine M.} and {Dorsan}, {Egenia} and {Huber}, {Tavis} and {Jamu}, {Styn M.} and {Stratford}, {Kristina} and {Samore}, {Matthew H.} and {Drews}, {Frank A.}},
year = {2026},
month = {jan},
journal = {Open Forum Infectious Diseases},
volume = {13},
number = {Supplement_1},
doi = {10.1093/ofid/ofaf695.1299},
url = {https://doi.org/10.1093/ofid/ofaf695.1299},
}