NEW research highlights the role of ventilator-capable nursing homes in the spread of antimicrobial-resistant pathogens, including the emerging multidrug-resistant fungus Candida auris, reinforcing concerns about their role in healthcare-associated infections.
Researchers used strain-resolved metagenomics and isolate sequencing to investigate the genomic epidemiology of C. auris in a nursing home setting. Skin colonisation and clonal spread of C. auris were examined in residents, alongside an analysis of other high-priority bacterial pathogens. The study also integrated clinical microbiology data to assess the presence of antimicrobial resistance genes at multiple skin sites. Additionally, publicly available shotgun metagenomic samples from residents of seven other nursing homes were analysed to evaluate bacterial strain sharing across different facilities.
The findings revealed extensive colonisation of C. auris on residents’ skin, as well as its spread throughout a metropolitan region. Most Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species (ESKAPE pathogens) were found to be shared among residents, along with other high-priority organisms such as Escherichia coli, Providencia stuartii, Proteus mirabilis, and Morganella morganii.
Carbapenemase genes, which confer resistance to last-line antibiotics, were detected at multiple skin sites on carriers. Further analysis of microbiome data from additional nursing homes confirmed widespread bacterial strain sharing, suggesting a broader pattern of pathogen transmission.
These findings emphasise the role of skin as a reservoir for antimicrobial-resistant pathogens in nursing homes, highlighting the urgent need for enhanced infection control strategies to curb their spread within and beyond these facilities.
Ada Enesco, EMJ
Reference
Proctor DM et al; NISC Comparative Sequencing Program. Clonal Candida auris and ESKAPE pathogens on the skin of residents of nursing homes. Nature. 2025; DOI: 10.1038/s41586-025-08608-9.
