Important sites and pathogens causing infections in long-term care facilities
- Michael J Richards, MD, FRACP
Michael J Richards, MD, FRACP
- The Royal Melbourne Hospital
- Victoria, Australia
- Rhonda L Stuart, MBBS, FRACP, PhD
Rhonda L Stuart, MBBS, FRACP, PhD
- Infectious Diseases Physician, Medical Director Infection Control
- Monash Health
Long-term care facilities (LTCFs) provide a unique environment favoring the transmission of infections to residents. Such infections are a form of non-nosocomial (outpatient) healthcare associated infections as opposed to hospital-acquired (nosocomial) healthcare associated infections.
As the population ages and technology improves to care for patients with previously fatal conditions, both the number and proportion of persons in LTCFs will increase. The incidence of infections in LTCFs is comparable to that in acute care hospitals in both total number and rate of infections . Residents of these institutions are subject to infections circulating in the community, those normally considered to be nosocomial, and those unique to persons with a wide range of disabilities.
Specific sites and pathogens responsible for infections in LTCFs as well as measures to prevent or control these infections will be reviewed here. The general issues involved in infection control in these facilities are discussed separately. (See "Principles of infection control in long-term care facilities".)
The IDSA clinical practice guidelines for the evaluation of fever and infection in long-term care facilities, along with other IDSA guidelines, are available at the IDSA's web site .
MAJOR TYPES OF INFECTIONS
Sites of infection that have particular importance in LTCFs include respiratory tract infection, gastroenteritis, skin and soft tissue infection, and urinary tract infection. Together these infections represent 94 percent of infections seen in LTCFs .
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- MAJOR TYPES OF INFECTIONS
- Infectious diarrhea and foodborne illness
- - Salmonella infections
- - Staphylococcal infections
- - E. coli O157:H7 infections
- - Prevention
- - Outbreaks
- Urinary tract infection
- Decubitus ulcers
- IMPORTANT PATHOGENS IN LTCF INFECTIONS
- Methicillin resistant Staphylococcus aureus
- Vancomycin resistant enterococci
- Multi-resistant gram-negative infections
- Clostridium difficile diarrhea
- Invasive group A streptococcal infections