Colonization After Discharge to a Community Setting: New York City, 2017-2019.

Background: Patients colonized with multidrug-resistant and discharged to a community setting can subsequently seek care in a different healthcare facility and might be a source of nosocomial transmission of .

Methods: We designed a case management pilot program for a cohort of New York City residents who had a history of positive culture identified during clinical or screening activities in healthcare settings and discharged to a community setting during 2017-2019. Approximately every 3 months, case managers coordinated colonization assessments, which included swabs of groin, axilla, and body sites yielding previously. Patients eligible to become serially negative were those with ≥2 colonization assessments after initial identification. Clinical characteristics of serially negative and positive patients were compared.

Results: The cohort included 75 patients. Overall, 45 patients were eligible to become serially negative and had 552 person-months of follow-up. Of these 45 patients, 28 patients were serially negative (62%; rate 5.1/100 person-months), 8 were serially positive, and 9 could not be classified as either. There were no clinical characteristics that were significantly different between serially negative and positive patients. The median time from initial identification to being serially negative at assessments was 8.6 months (interquartile range, 5.7-10.8 months).

Conclusions: A majority of patients, assessed at least twice after identification, no longer had detectable on serial colonization assessments.