scholarly journals Prospective assessment of catheter-associated bacteriuria in nursing home residents: clinical presentation, epidemiology, and colonization dynamics

2020 ◽  
Author(s):  
Chelsie Armbruster ◽  
Aimee Brauer ◽  
Monica Humby
Keyword(s):  
Nursing Home ◽  
Pathogenic Bacteria ◽  
Clinical Presentation ◽  
Nursing Home Residents ◽  
Signs And Symptoms ◽  
Antimicrobial Treatment ◽  
Resistant Bacteria ◽  
Prospective Assessment ◽  
Colonization Dynamics ◽  
Definition Of

Background: Long-term catheterization facilitates continuous bacteriuria, for which the clinical significance is unclear. The objectives of this study were to determine the clinical presentation, epidemiology, and dynamics of bacteriuria in a cohort of catheterized nursing home residents. Methods: Prospective weekly urine collection, culture, urinalysis, chart review, and assessment of possible signs and symptoms of infection for 19 study participants over 260 weeks. All bacteria ≥103 cfu/ml were isolated, identified, and subjected to select antimicrobial testing. Results: From 234 urine samples, 1,092 bacteria were isolated and 286 (26%) were resistant to a tested antimicrobial. 226 urines were polymicrobial (97%), with an average of 4.7 isolates per weekly specimen. 233 urines (99%) exhibited >103 CFU/ml, 220 (94%) exhibited abnormal urinalysis, 77 (33%) were associated with at least one sign or symptom of infection, 51 (22%) met a standardized definition of CAUTI, and 3 (1%) had a corresponding caregiver diagnosis of CAUTI. Bacteriuria composition was remarkably stable, but catheter changes and antimicrobial treatment resulted in a net increase of 1.9 and 0.3 isolates per participant, respectively, and represented a source of new acquisition of antimicrobial resistant bacteria. Conclusions: Catheterized individuals exhibit a high baseline prevalence of bacteriuria involving pathogenic bacteria and potential indicators of infection. Bacteriuria composition is largely polymicrobial and stable, and includes organisms previously considered to be urine culture contaminants. However, catheter changes and antimicrobial treatment may do more harm than good in this patient population. Funding: This work was supported by the NIH (R00 DK105205, R01 DK123158, UL1 TR001412)

scholarly journals Signs and Symptoms Associated With Earlier Dialysis Initiation in Nursing Home Residents

2010 ◽  
Vol 56 (6) ◽  
pp. 1117-1126 ◽  
Author(s):  
Manjula Kurella Tamura ◽  
Ann M. O'Hare ◽  
Charles E. McCulloch ◽  
Kirsten L. Johansen
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Signs And Symptoms ◽  
Dialysis Initiation

scholarly journals Applications of the new ESPEN definition of malnutrition and SARC-F in Chinese nursing home residents

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Ming Yang ◽  
Zhaojing Huang ◽  
Jing Chen ◽  
Jiaojiao Jiang ◽  
Yun Zuo ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Definition Of

scholarly journals Rectal Colonization by Drug Resistant Bacteria in Nursing Home Residents in Crete, Greece

2021 ◽  
Vol 6 (3) ◽  
pp. 123
Author(s):  
Aikaterini Moschou ◽  
Petros Ioannou ◽  
Eleni Moraitaki ◽  
Dimitra Stafylaki ◽  
Sofia Maraki ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Resistant Bacteria ◽  
Antimicrobial Use ◽  
Drug Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Drug Resistant Bacteria ◽  
High Prevalence ◽  
Rectal Colonization

(1) Background: In an area with a high prevalence of multi-drug resistant Gram-negative bacteria (MDR-GNB), we investigated the colonization of nursing home residents by such organisms. (2) Methods: A point prevalence study was performed in six nursing homes of the Heraklion area on the island of Crete. A rectal swab was taken and cultured from each participant, while additional risk factors such as recent hospitalization or antimicrobial usage were recorded and evaluated. (3) Results: A total of 137 nursing home residents were included in the study. Their mean age was 82.1 years and 19.7% were males. In total, cultures yielded 255 GNB; E. coli, K. pneumoniae and P. aeruginosa were the most common. Among the microorganisms cultured, 17.6% had the extended-spectrum beta-lactamase phenotype, while 18% were MDR. A statistically significant association was found between recent antimicrobial use and colonization by MDR-GNB; (4) Conclusions: Colonization by MDR-GNB was found to be highly prevalent in nursing home residents. Recent antimicrobial use was associated with MDR-GNB carriage.

scholarly journals Defining Your “Life Territory”: The Meaning of Place and Home for Community Dwellers and Nursing Home Residents—A Qualitative Study in Four European Countries

2022 ◽  
Vol 19 (1) ◽  
pp. 517
Author(s):  
Fiona Ecarnot ◽  
Stéphane Sanchez ◽  
Gilles Berrut ◽  
Véronique Suissa ◽  
Serge Guérin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Older People ◽  
New Technologies ◽  
Nursing Home Residents ◽  
European Countries ◽  
Social Contacts ◽  
Working Definition ◽  
Definition Of ◽  
Multidimensional Concept ◽  
Community Dwellers

The meaning of place and home for community dwellers and nursing home residents remains unclear. We explored the relationship between older people and their “life territory”, to propose a working definition of this concept, which could be used to orient policy decisions. Individual, semi-structured interviews were performed with older people, nursing home staff, and representatives of local institutions/elected officials in four European countries (France, Belgium, Germany, Italy). Interviews were transcribed and analysed using thematic analysis. In total, 54 interviews were performed. Five main themes emerged: (i) working definition of “your life territory” (a multidimensional concept covering individual and collective aspects); (ii) importance of the built environment (e.g., public transport, sidewalks, benches, access ramps); (iii) interactions between nursing homes and the outside community (specifically the need to maintain interactions with the local community); (iv) a sense of integration (dependent on social contacts, seniority in the area, perceived self-utility); and (v) the use of new technologies (to promote integration, social contacts and access to culture). This study found that the “life territory” of older people is a multidimensional concept, centred around five main domains, which together contribute to integrating older people into the fibre of their community.

scholarly journals Reliability of nonlocalizing signs and symptoms as indicators of the presence of infection in nursing-home residents

2020 ◽  
pp. 1-10
Author(s):  
Theresa A. Rowe ◽  
Robin L.P. Jump ◽  
Bjørg Marit Andersen ◽  
David B. Banach ◽  
Kristina A. Bryant ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Drug Effects ◽  
Signs And Symptoms ◽  
Antibiotic Use ◽  
Drug Dose ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Clostridioides Difficile

Antibiotics are among the most common medications prescribed in nursing homes. The annual prevalence of antibiotic use in residents of nursing homes ranges from 47% to 79%, and more than half of antibiotic courses initiated in nursing-home settings are unnecessary or prescribed inappropriately (wrong drug, dose, or duration). Inappropriate antibiotic use is associated with a variety of negative consequences including Clostridioides difficile infection (CDI), adverse drug effects, drug–drug interactions, and antimicrobial resistance. In response to this problem, public health authorities have called for efforts to improve the quality of antibiotic prescribing in nursing homes.

scholarly journals FACILITY AND RESIDENT LEVEL DIFFERENCES: ANTIBIOTIC USE IN NURSING HOMES FOR RESIDENTS WITH ADVANCE DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S883-S883
Author(s):  
Meghan Hendricksen ◽  
Daniel Habtemariam ◽  
Susan Mitchell
Keyword(s):  
Infectious Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nurse Practitioners ◽  
Nursing Home Residents ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Antimicrobial Use ◽  
Full Time ◽  
Advanced Dementia

Abstract Previous studies have shown that there is a high frequency of antibiotic use in NH for advance dementia patients. However, research has shown limited clinical benefit from antimicrobial use for this population, and antimicrobial exposure increases colonization with drug-resistant bacteria in nursing homes. The aim of this study was to identify NH and resident level characteristics associated with antibiotic use for patients with advance dementia. Using data from an ongoing cluster RCT in 28 Boston NHs; Trial to Reduce Antimicrobial use in Nursing home residents with Alzheimer’s disease and other Dementias (TRAIN-AD), testing a program intervention to improve management of infections in advanced dementia. These data are taken from baseline measurements 2 months prior to intervention, and individual nursing home residents with advance dementia are units of analysis (n = 425). We ran multivariable logistic regression model with antibiotic use as the outcome, adjusting for clustering at NH level, with NH (#beds, profit status, staffing, #cognitively impaired, etc.) and individual patient characteristics (age, gender, race, etc.) as independent variables. Analyses found residents were more likely to receive antibiotics if they resided in nursing homes that employed less intense infectious disease practices prior to baseline (AOR = 2.34; 95% CI 1.08, 5.05), and full-time nurse practitioners or physician assistants (AOR= 3.68; 95%CI 1.49, 9.04). Female patients also had higher odds of receiving antibiotics (AOR=2.16; 95%CI1.10, 4.67). These findings provide potential insight into the importance of education regarding stringent infectious disease practices for practitioners, particularly for patients with advanced dementia.

Views on Dignity of Elderly Nursing Home Residents

2006 ◽  
Vol 13 (2) ◽  
pp. 130-146 ◽  
Author(s):  
Lise-Lotte Franklin ◽  
Britt-Marie Ternestedt ◽  
Lennart Nordenfelt
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Sense Of Coherence ◽  
Nursing Home Residents ◽  
Chronic Illnesses ◽  
Western World ◽  
Structured Interviews ◽  
Hermeneutic Approach ◽  
Definition Of

Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews. A total of 39 interviews were transcribed. The analysis revealed three themes: (1) the unrecognizable body; (2) fragility and dependency; and (3) inner strength and a sense of coherence.

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