Contributed Commentary By Evan Jones
January 28, 2020 | The benefits of proper infection control are well-known in the long-term care community. Reducing transmission and limiting the number of individuals afflicted by a particular strain are primary goals in facilities where patients are considered high-risk and live in close proximity to one another. Facilities with lower infection rates can attract skilled nursing talent as well as more patients, two things which are crucial to a successful business. Not to mention, faster and more effective treatment and eradication of infections can lower costs by cutting down on antibiotics used and hours of productivity spent trying to diagnose conditions.
Of course, since elderly patients in these facilities are high-risk for contracting multi-drug resistant pathogens, their caregivers have their work cut out for them when it comes to infection prevention and treatment. Long-term care patients are more likely to use catheters and other medical devices, which can spread infection. They also may have preexisting conditions which could interact with prescriptions or cognitive impairments which make it hard for them to effectively communicate their symptoms to doctors. In instances like these, newly-developed diagnostic and data sharing technologies have the potential to change how infections are understood and treated in long-term care.
Reduce Guesswork and Uncertainty with Faster Diagnostics
Some of the most common infections seen in long-term care patients are urinary tract infections (UTIs). Unsurprisingly, high-risk patients in long-term care are more likely to be afflicted with complicated UTIs, which generally won’t respond to the same courses of antibiotics that doctors and nurses fall back on. Mismanagement of these infections and misuse of antibiotics result in dangerous cognitive side-effects, lengthy hospital stays and increased risk of transmission to other patients. Not to mention the risk of contributing to antibiotic-resistance when frontline therapeutics are administered to a patient unnecessarily.
Throughout the healthcare industry there is growing demand for faster and more reliable diagnostic tests capable of accurately identifying UTIs and other dangerous drug-resistant pathogens and shortening the time to diagnosis and treatment. Treating a patient with a frontline antibiotic before you have obtained their test results, while seemingly a quick and easy solution to address discomfort, can result in unintended negative consequences such as increased drug resistance and lead to transmission from that individual to others in the facility if left unaddressed.
On the bright side, rapid diagnostic tests currently undergoing trials in clinical settings are capable of producing results in hours, rather than days. This shortened timeframe encourages doctors and nurses to wait for a complete picture of the patient’s condition and identify the most-effective treatment instead of over-relying on antibiotics.
Data-Sharing For Informed Decision-Making Across Facilities
Let’s take a step back for a moment and look at the global fight against drug-resistant superbugs. A major challenge stems from knowledge gaps between healthcare facilities across regions and countries. Without reliable data-sharing infrastructure in place, doctors may be unaware of similar cases and pathogen information from which they can draw treatment insights. On a broader scale, medical professionals have a harder time tracking outbreaks and identifying superbug threats within health networks. This issue is especially serious in long-term care and nursing settings where records kept by staff aren’t easily transferrable when a patient is sent to a specialist or emergency room in an urgent situation. Adding to the issue is the likelihood that long-term care patients have comorbidities or pre-existing conditions that need to be considered, ones which they might not be able to communicate due to their age or cognitive abilities.
To address this challenge, informatics solutions which create a unified database of infectious disease and drug-resistant pathogen data are being piloted in hospital systems. These platforms collect large amounts of genotype and phenotype data from clinical isolates at facilities on an ongoing basis, the result of which is a database that can be accessed by doctors to compare results from a single patient against a larger population. This means a doctor can take the diagnosis of a long-term care patient and identify commonalities among other cases, even if they were not handled at that particular facility or the patient’s records are housed elsewhere. With a more accurate diagnosis and clear understanding of broader infection trends, doctors can make informed decisions on whether or not to use antibiotics as well as which strains might be most effective.
As pathogen identification and surveillance software become more commonly-used in hospitals, it offers a tremendous value to long-term care facilities as well. The combination of rapid diagnostics and pathogen data can help bridge the records gap in long-term care and provide caregivers with more accessible insights on high-risk infection patients. At the end of the day, these technologies will help healthcare professionals work toward the common goal of improving patient outcomes, reducing infection transmission and losing time, resources and money during the diagnostic process.
Evan Jones is the CEO of OpGen, Inc., a pioneering informatics and genomic analysis company providing complete solutions for patient, hospital, and network-wide infection prevention and treatment. He can be reached at ejones@opgen.com.