Bacterial infection in elderly nursing home and community-based patients: a prospective cohort study

Zorman, Jerneja Videčnik; Lusa, Lara; Strle, Franc; Maraspin, Vera

doi:10.1007/s15010-013-0469-0

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…The most common cause of hospitalization in nursing home patients is infection, and almost 14% of elderly patients admitted to the hospital are admitted for infection [2]. Infectious diseases-related emergency department visits have been shown to increase greatly with age among the young-old (65–74 years), middle-old (75–84 years), and old-old (85+ years) age groups [3].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application

et al. 2016

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The elderly population can be divided into three distinct age groups: 65–74 years (young-old), 75–84 years (middle-old), and 85+ years (old-old). Despite evidence of a shift in leading causes for mortality in the elderly from infectious diseases to chronic conditions, infections are still a serious cause of death in this population. These patients are at increased risk due to weakened immune systems, an increased prevalence of underlying comorbidities, and decreased physiologic reserves to fight infection. Additionally, elderly patients, especially adults in institutional settings, are at an increased risk of colonization and subsequent infection with methicillin-resistant Staphylococcus aureus at a rate that is five times higher than in younger individuals, causing an increase in empiric and definitive vancomycin use. Elderly patients have unique characteristics that make dosing vancomycin a challenge for clinicians, such as increased volume of distribution and decreased renal function. Using the best available evidence, it is recommended to initiate lower empiric maintenance doses and monitor vancomycin serum concentrations earlier than steady state to accurately calculate drug elimination and make appropriate dose adjustments.

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Section: Introductionmentioning

confidence: 99%

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application

et al. 2016

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“…Almost 5% of the elderly population of Europe and the United States will die as a consequence of infectious disease, while this proportion is expected to be around 20% in Africa (WHO ; Videcnik Zorman et al . ).…”

Section: Introductionmentioning

confidence: 97%

“…Although the majority of the elderly population live in the community, long‐term care residents are more often admitted to emergency departments and hospital units for infection; these infections are of greater severity and have greater associated mortality than those seen in community dwellers (Yoshikawa ; Videcnik Zorman et al . ; Steens et al . ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of probiotics for preventing infections in the elderly: Systematic review and meta‐analysis – study protocol

Wachholz

Nunes

et al. 2015

Nutrition Bulletin

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Older persons have greater susceptibility to infections than younger adults, with generally more severe and atypical episodes. Probiotics are living microorganisms that confer a health benefit to the host when administered in sufficient quantities. Studies in older people receiving probiotic supplementation suggest a potential role of probiotics in infection prevention. We present a systematic review protocol aimed to assess the efficacy of probiotics in the prevention of community acquired infection in elderly people living either in the community or in long‐term care facilities. We will include only randomised controlled trials (RCTs). We will comply with the recommendations of the Cochrane Collaboration and the principles PRISMA Statement. This protocol is registered in the PROSPERO database (CRD42014013707).

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“…People residing in nursing homes are at increased risk for infection [1, 2]. Transmission occurs through transfer from colonized or infected individuals, transfer from the hands of health care workers, and contact with contaminated objects in the environment [3].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates

et al. 2017

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BackgroundThe focus of nursing home infection control procedures has been on decreasing transmission between healthcare workers and residents. Less evidence is available regarding whether decontamination of high-touch environmental surfaces impacts infection rates or resident outcomes. The purpose of this study was to examine if ultraviolet disinfection is associated with changes in: 1) microbial counts and adenosine triphosphate counts on high-touch surfaces; and 2) facility wide nursing home acquired infection rates, and infection-related hospitalization.MethodsThe study was conducted in one 160-bed long-term care facility. Following discharge of each resident, their room was cleaned and then disinfected using a newly acquired ultraviolet light disinfection device. Shared living spaces received weekly ultraviolet light disinfection. Thirty-six months of pretest infection and hospitalization data were compared with 12 months of posttest data. Pre and posttest cultures were taken from high-touch surfaces, and luminometer readings of adenosine triphosphate were done. Nursing home acquired infection rates were analyzed relative to hospital acquired infection rates using analysis of variance procedures. Wilcoxon signed rank tests, The Cochran’s Q, and Chi Square were also used.ResultsThere were statistically significant decreases in adenosine triphosphate readings on all high-touch surfaces after cleaning and disinfection. Culture results were positive for gram-positive cocci or rods on 33% (n = 30) of the 90 surfaces swabbed at baseline. After disinfectant cleaning, 6 of 90 samples (7.1%) tested positive for a gram-positive bacilli, and after ultraviolet disinfection 4 of the 90 samples (4.4%) were positive. There were significant decreases in nursing home acquired relative to hospital-acquired infection rates for the total infections (p = .004), urinary tract infection rates (p = .014), respiratory system infection rates (p = .017) and for rates of infection of the skin and soft tissues (p = .014). Hospitalizations for infection decreased significantly, with a notable decrease in hospitalization for pneumonia (p = .006).ConclusionsThis study provides evidence that the pulsed-xenon ultraviolet disinfection device is superior to manual cleaning alone for decreasing microbes on environmental surfaces, as well as decreasing infection rates, and the rates of hospitalization for infection. Results suggest that placing a stronger emphasis on environmental surface disinfection in long-term care facilities may decrease nursing home acquired infections.

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Bacterial infection in elderly nursing home and community-based patients: a prospective cohort study

Cited by 13 publications

References 27 publications

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application

Effectiveness of probiotics for preventing infections in the elderly: Systematic review and meta‐analysis – study protocol

Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates

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