Stopping Infection Outbreaks in Their Tracks With Diagnostic Technology

By Evan Jones

Professionals working in geriatric medicine and long term care facilities understand how disruptive infections can be to patients under their care. These patients are considered high risk for multidrug-resistant organism infections for a number of reasons, including their age, tendency to have weakened immune systems, increased use of catheters and other medical devices, and comorbidities or preexisting conditions.

Additionally, long term care patients are more likely to be physically and/or cognitively impaired and therefore unable to communicate symptoms and discomfort to caregivers and doctors that could tip them off to a possible infection. The combination of these factors could result in an infection going unnoticed for a longer period of time in a long term care patient, creating opportunities for it to spread to others in the same facility.

In geriatric settings, it’s very easy for an outbreak event to become a crisis. Recently, long term care facilities were found to have a nine times higher rate of Klebsiella pneumoniae bacteria, which is responsible for many health care-associated infections such as pneumonia, bloodstream/surgical-site infections, and meningitis, and is often resistant to common classes of antibiotics. Health care professionals have taken note of this issue and are working hard to find new tools and best practices that help diagnose and treat these pathogens faster and more effectively, preventing dangerous transmission events that can cripple long term care facilities.

Infection Control and Stewardship
When elder patients are suspected to have an infection, the primary goal of their caregivers and facility staff is typically twofold: eradicate the infection in the individuals and prevent transmission to other patients around them. The sooner an infection can be brought under control and treated in a single patient, the less likely it is for that infection to spread to others within the same care center or hospital. When a patient is suspected to have an infection, the first step for caregivers often is to administer antibiotics, sometimes even before a definitive diagnosis is obtained.

However, as mentioned previously, many of the most common infections in long term care facilities are becoming resistant to the first-line antibiotics caregivers fall back on for treatment. This has led to an increased focus on antimicrobial stewardship, or the practice of improving the use of antimicrobial medicines to enhance patient outcomes, while also cutting costs and lowering the risk of resistance to antibiotics. Stewardship programs might include more strict monitoring of antibiotic prescription and consumption or the implementation of additional checkpoints a caregiver must go through before procuring a particular antibiotic for a patient.

In addition to stewardship programs, hospitals and health care facilities are placing an increased focus on policies that reduce infection transmission. This includes everything from prioritizing frequent handwashing and disinfecting practices to enforcing strict isolation procedures for infected patients. These best practices should be standard protocol regardless of whether there’s a transmission event taking place within a facility.

In addition to improving individual patient outcomes, the successful implementation of stewardship and infection control programs leads to lower infection rates across a facility. Faster diagnoses enable caregivers to identify the most effective treatment in less time, cutting costs by reducing wasted productivity and resources. New digital health technologies can further shorten wait times for accurate diagnoses, while also gathering data on infection strains and treatment courses that health care professionals can utilize when approaching future infection cases.

Bringing Faster Treatment to High-Risk Patients
Health care professionals working at all levels, from patient care to administration, recognize a need for new tools that can control infection outbreaks and improve results. This is especially important in long term care due to the large population of high-risk patients in these facilities. In elderly patients, a misdiagnosed or mistreated infection can lead to dangerous side effects such as confusion in an individual who might already be cognitively impaired or distressed.

Since antibiotic-resistant infections often present themselves in similar ways or can be mistaken for other conditions common in elderly populations such as dementia, it’s important for caregivers working with geriatric patients to obtain an accurate diagnosis before moving forward with treatment. Faster diagnostic tests are emerging that will encourage doctors and nurses to wait for more reliable results, which can then be used to identify an effective treatment plan to eradicate the infection before it progresses and has the chance to be transmitted to others.

Bridging the Records Gap With Digital Health Solutions
Digital health solutions are proving to be a tremendous value add for rapid diagnostic platforms in health care facilities. Managing health records for elderly patients can be challenging, as these individuals frequently move in and out of different facilities and may have trouble advocating for themselves. This group is also more likely to have more complicated medical records, which could include preexisting health conditions, medications they take, and history of surgical procedures.

Despite the best efforts of those working at long term care and nursing centers, comprehensive records can easily be left behind if a patient is transferred to another facility, particularly in an emergency. To address this challenge, biotechnology companies are introducing digital solutions that create a database of infectious and antibiotic-resistant pathogens, using the results of rapid diagnostic tests. Health care professionals can tap into this registry to gain information on which treatments might be best suited for particular infection strains, based on past patient outcomes. It can also reveal insights into how transmission events occur, to improve infection control protocols and protect facilities from future outbreaks.

Major hospital systems and state health departments are already adopting these digital health applications in an effort to create multihospital surveillance networks based on shared infection and treatment data that can be accessed in real time. Given the need for infection control support for high-risk patients, these technologies have the potential to be adopted by long term care and geriatric medicine facilities to improve patient outcomes, cut down on costs, and prevent outbreaks.

— Evan Jones is the CEO of OpGen, Inc, a pioneering informatics and genomic analysis company providing complete solutions for patient, hospital, and networkwide infection prevention and treatment.