Nosocomial Infections in Geriatric Long-Term-Care and Rehabilitation Facilities: Exploration in the Development of a Risk Index for Epidemiological Surveillance

2001 ◽  
Vol 22 (12) ◽  
pp. 746-753 ◽  
Author(s):  
Franck Golliot ◽  
Pascal Astagneau ◽  
Bernard Cassou ◽  
Nicole Okra ◽  
Monique Rothan-Tondeur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Risk Index ◽  
Epidemiological Surveillance ◽  
Prevalence Survey ◽  
Term Care ◽  
Risk Indices ◽  
Rehabilitation Facilities ◽  
Geriatric Long Term Care

AbstractObjective:To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities.Design:Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly.Setting:248 geriatric units in 77 hospitals located in northern France.Participants:All hospital inpatients on the day of the survey were included.Results:Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity.Conclusion:The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.

Prevalence, risk factors and molecular epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) colonization in residents of long-term care facilities in Luxembourg, 2010

2012 ◽  
Vol 141 (6) ◽  
pp. 1199-1206 ◽  
Author(s):  
J. MOSSONG ◽  
E. GELHAUSEN ◽  
F. DECRUYENAERE ◽  
A. DEVAUX ◽  
M. PERRIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Previous History ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
History Of ◽  
Independent Risk Factors ◽  
Mrsa Colonization

SUMMARYA prevalence survey of methicillin-resistantStaphylococcus aureus(MRSA) was performed in 2010 in 19 long-term care facilities in Luxembourg. Of the 954 participating residents, 69 (7·2%) were colonized by MRSA. Previous history of MRSA [odds ratio (OR) 7·20, 95% confidence interval (CI) 3·19–16·27], quinolone therapy in the previous year (OR 2·27, 95% CI 1·17–4·41) and ⩾24 h care administered per week (OR 4·29, 95% CI 1·18–15·56) were independent risk factors for MRSA colonization. More than 75% of strains were of clonal complex (CC)5, mainlyspa-type t003 or sequence type (ST)225 and ST710, which is a rapidly emerging lineage prevalent in central Europe. Five residents were colonized by livestock-associated genotypes belonging to CC398. Previously dominant CC8 strains have recently been replaced by more resistant CC5 strains in Luxembourg.

Infections and use of antibiotics in residents of long-term care facilities in Hungary

2014 ◽  
Vol 155 (23) ◽  
pp. 911-917 ◽  
Author(s):  
Rita Szabó ◽  
Karolina Böröcz
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Soft Tissues ◽  
Good Practice ◽  
Antibiotic Use ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with 11,823 residents participated in the point-prevalence survey in May, 2013. Results: The prevalence of infections was 2.1%. Skin and soft tissues infections were the most frequent (36%), followed by infections of the respiratory (30%) and urinary tract (21%). Antimicrobials were mostly prescribed for urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common antimicrobials (97.5%) belonged to the ATC J01 class of “antibacterials for systemic use”. Conclusions: The results emphasise the need for a national guideline and education for good practice in long-term care facilities. Orv. Hetil., 2014, 155(23), 911–917.

Design and Development of a Web-based Delirium Preventive Application for Long-term Care Facilities: A Methodological Study (Preprint)

2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Cloud System ◽  
Evidence Based ◽  
Methodological Study ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Delirium Prevention

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

Incidence and risk factors of hospital falls on long-term care wards in Japan

2011 ◽  
Vol 18 (3) ◽  
pp. 572-577 ◽  
Author(s):  
Buichi Tanaka ◽  
Mio Sakuma ◽  
Masae Ohtani ◽  
Jinichi Toshiro ◽  
Tadashi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Term Care

scholarly journals Spread of CTX-M-type ESßLs in isolates of E. coli from long-term care and rehabilitation facilities in Northern Italy

2008 ◽  
Vol 23 (3) ◽  
Author(s):  
Elisabetta Nucleo ◽  
Roberta Migliavacca ◽  
Michela Balzaretti ◽  
Fabiola Martino ◽  
Melissa Spalla ◽  
...  
Keyword(s):  
Long Term Care ◽  
Northern Italy ◽  
Term Care ◽  
E Coli ◽  
Rehabilitation Facilities

scholarly journals Association Between Length of Residence and Prevalence of Mrsa Colonization Among Residents in Geriatric Long-term Care Facilities

2020 ◽  
Author(s):  
Teppei Sasahara ◽  
Ryusuke Ae ◽  
Akio Yoshimura ◽  
Koki Kosami ◽  
Kazumasa Sasaki ◽  
...  
Keyword(s):  
Long Term Care ◽  
Length Of Residence ◽  
Term Care ◽  
Initial Testing ◽  
High Prevalence ◽  
Care Facilities ◽  
Cross Transmission ◽  
Mrsa Colonization ◽  
Geriatric Long Term Care

Abstract Background: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs.Methods: We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n=204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n=79).Results: Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p=0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing.Conclusions: The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs is most likely to be associated with resident transfer rather than spread via cross-transmission inside LTCFs.

Risk Factors for Depression in Long-Term Care: A Systematic Review

2018 ◽  
Vol 42 (3) ◽  
pp. 224-237 ◽  
Author(s):  
Rebecca Chau ◽  
David W. Kissane ◽  
Tanya E. Davison
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Long Term Care ◽  
Term Care

Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group

2018 ◽  
Vol 24 (9) ◽  
pp. 769-772 ◽  
Author(s):  
Hideharu Hagiya ◽  
Norihisa Yamamoto ◽  
Ryuji Kawahara ◽  
Yukihiro Akeda ◽  
Rathina Kumar Shanmugakani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multicentre Study ◽  
Long Term Care ◽  
Study Group ◽  
Care Hospital ◽  
Term Care ◽  
Fecal Carriage
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