Frequent Infections in Long Term Care

By 2030, nearly 19% of the US population will be 65 years of age or older and it is estimated that 5.3 million will require nursing home (NH) care. The prevalence of infections in NHs can reach 32%. Residents who acquire infections are at greater risk for worsening health complications, hospitalizations, and increased medical costs. Advancing age with its associated medical conditions such as dementia and indwelling devices such as feeding tubes or urinary catheters predispose NH residents to infections. In addition, as we age our natural ability to fight or resist infection declines. All these factors make infection risk for residents in nursing homes an important concern.

Common infections of NH residents arise from the urine, respiratory system (lungs), gastrointestinal system, and skin. Respiratory system infections include pneumonia and influenza which can lead to serious and even fatal illness in NH residents. Older adults may not always exhibit typical signs of respiratory infections such as fever, chills, or pain in chest. Prompt recognition and treatment is needed to avoid complications. Preventing respiratory illnesses in NHs includes ensuring all residents receive yearly influenza and pneumonia vaccines. Another successful strategy in reducing influenza outbreaks in NH is annual immunization of NH healthcare workers. Also, if an outbreak occurs preventive therapy with oral medications may be used.

Urinary tract infections (UTI) are the most common infections NH residents, especially those with urinary catheters. Virtually all residents with a urinary catheter will have bacteria in the urine 30 days after placement of the catheter. The bacteria in the urine can sometimes cause a symptomatic UTI, requiring antibiotic treatment but often the resident is treated with an antibiotic for bacteria in the urine that is not making the resident ill. Inappropriate treatment of UTIs leads to antibiotic resistance decreasing the number of effective antibiotics available when the resident does become ill with symptoms of a UTI. Furthermore, an unintended consequence of antibiotic use is a diarrheal illness called Clostridium difficile which is responsible for nearly 29,000 deaths annually. Prevention of UTIs can be accomplished by reducing the number of urinary catheters in the NH residents and good hand hygiene practices.

A common epidemic in NH is gastrointestinal (GI) illness. GI illnesses are often food borne. The older adult’s decreased production of stomach acid increases risk for the GI illness, such as norovirus, and can lead to dehydration. Numerous NH residents can be infected if outbreak is not promptly recognized, and appropriate isolation and proper disinfection procedures are initiated. Again, excellent hand-washing hygiene will also further limit the spread of GI illness.

Lastly, NH residents often acquire skin infections. Residents with open wounds have greater risk for infections. Working towards increased mobility, optimal hydration, excellent nutrition and good skin care of incontinent residents helps to prevent the development of open wounds (bed sores).

By being aware of the types and risks for infection and strategies to prevent them you can help your loved ones by recognizing these risks and prevention methods to limit or prevent infections and their complications.

For more information reach out to ID Care at 908.281.0221 or IDCARE.COM

ID CARE – The largest enterprise in New Jersey dedicated to the identification, treatment, and prevention of infectious diseases. ID CARE is the right specialist to get the right care.