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Infectious Diseases and Death Among Nursing Home Residents: Results of Surveillance in 13 Nursing Homes

Published online by Cambridge University Press:  02 January 2015

Consuelo Beck-Sague ,
Elsa Villarino ,
Diane Giuliano ,
Sharon Welbel ,
Lisa Latts ,
Lilia M. Manangan ,
Ronda L. Sinkowitz  and
William R Jarvis
Consuelo Beck-Sague
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Elsa Villarino
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Diane Giuliano
Affiliation:
Hospital Services Laboratory, Garden Grove, California
Sharon Welbel
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa Latts
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lilia M. Manangan
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Ronda L. Sinkowitz
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
William R Jarvis*
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Investigations and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333
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Abstract

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1,754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150,17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P=0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P= 0.01) and (7 of 127 versus 9 of 708; P= 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population.

Type
From the Third International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 7 , July 1994 , pp. 494 - 496
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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Footnotes

*

Ms. Giuliano currently is Director of the Women Veterans Program, VA Medical Center, Long Beach, California.

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