Infection Management for Geriatrics in Long-Term Care Facilities, Second Edition

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ISBN: 9780849398933 | 0849398932
Cover: Hardcover
Copyright: 9/14/2006

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Offering an authoritative overview of all infection management protocols currently utilized by infectious disease specialists, geriatricians, and infection control practitioners, this Second Edition examines current strategies to diagnose, treat, control, and prevent common infectious diseases in long-term care geriatric facilities. Covering a wide range of infectious conditions, this source presents new chapters on conjunctivitis, otitis, sinusitis, HIV, SARS, and the West Nile Virus.

Preface to the Second Edition

Preface to the First Edition

vii

Acknowledgment

Contributors

xxv

PART I: PRINCIPLES OF AGING, LONG-TERM CARE, AND INFECTION

1. Demographics and Economics of Long-Term Care

(14)

A. Jefferson Lesesne and Joseph G. Ouslander

Key Points

(1)

Introduction

(1)

Demand for Nursing Facility Care

(6)

Economics of LTC

(3)

Evolving Changes in LTC

(1)

References

(3)

2. Epidemiology and Special Aspects of Infectious Diseases in Aging

(6)

Thomas T. Yoshikawa

Key Points

(1)

Conceptual Basis for Importance of Infection and Aging

(2)

Special Aspects of Infections in the Elderly

(2)

Suggested Reading

(1)

References

(2)

3. Evaluation of Infections in Long-Term Care Facilities Versus Acute Care Hospitals

(10)

Arnel M. Joaquin

Key Points

(1)

Introduction

(4)

When to Transfer Long-Term Care Facilities Residents to an Acute Care Setting

(2)

Summary

(1)

Suggested Reading

(1)

References

(3)

4. Role of Functional Assessment in Evaluating and Managing Infections in Long-Term Care

(18)

Barbara J. Messinger-Rapport and Robert M. Palmer

Key Points

(1)

Introduction

(5)

Importance of Functional Assessment During Transitions of Care

(5)

Functional Assessment in LTC

(1)

Process of Functional Assessment

(3)

Infection Control and Function

(1)

Summary

(1)

Suggested Reading

(1)

References

(2)

5. Impaired Immunity and Increased Risk of Infections in Older Adults: Impact of Chronic Disease on Immunosenescence

(22)

Steven C. Castle, Koichi Uyemura, and Takashi Makinodan

Key Points

(1)

Introduction

(1)

Immunosenescence

(7)

Impaired Immunity Due to the Impact of Chronic Illness on an Aging Immune System (Immunosenescence)

(2)

Inflammatory Mediators and Immunity

(3)

Impact of Age and Chronic Illness–Related Impaired Immunity on Infections

(4)

Concluding Remarks

(1)

Suggested Reading

(1)

References

(3)

6. Nutrition and Infection

(16)

Kevin P. High

Key Points

(1)

Introduction

(1)

Prevalence and Causes of Malnutrition in Older Residents of LTCFs

(3)

Assessment of Nutritional Status and Consequences of Malnutrition in Long-Term Care Residents

(2)

Nutritional Interventions to Reduce Infection and Improve Outcomes in LTCF Residents

(2)

Specific Syndromes Where Nutritional Supplementation May Be of Benefit

(3)

Drug–Nutrient Interactions

(1)

Conclusions

(2)

Suggested Reading

(1)

References

(3)

7. Ethical Issues of Infectious Disease Interventions

(18)

Elizabeth L. Cobbs

Key Points

(1)

Introduction

(1)

Elements of Ethics

(2)

Everyday Ethics

(1)

The Doctor–Patient Relationship

(1)

Goals of Care and Advance Care Plans

(1)

Interventions: Burdens and Benefits

(1)

Quality of Life

(1)

Health Promotion

(1)

Health-Care Decision Making

(3)

Role of the Interdisciplinary Team

(1)

Role of the Medical Director

(1)

Advanced Dementia

(1)

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

(1)

End-of-Life Care

(1)

Infection Control Practices

100

(1)

Cost Concerns

100

(1)

Research Issues

101

(1)

The Future

101

(1)

Suggested Reading

102

(1)

References

102

(3)

PART II: PRINCIPLES OF MANAGING INFECTIONS IN LONG-TERM CARE FACILITIES

8. Clinical Manifestations of Infections

105

(10)

Dean C. Norman and Megan Bernadette Wong

Key Points

105

(1)

Introduction

106

(1)

Atypical Presentations of Infection

107

(1)

Fever

108

(3)

Conclusion

111

(1)

Suggested Reading

111

(1)

References

111

(4)

9. Establishing an Infection Control Program

115

(16)

Lona Mody

Key Points

115

(1)

Background

116

(1)

Unique Challenges to Infection Control

116

(2)

Regulatory Aspects of Infection Control

118

(1)

Components of Infection Control

119

(8)

Infection Control Practitioner

127

(1)

Review Committee

127

(1)

Resources for Infection Control Practitioners and Suggested Reading

128

(1)

References

128

(3)

10. Epidemiologic Investigation of Infectious Disease Outbreaks in Long-Term Care Facilities

131

(18)

Chesley L. Richards, Jr. and William R. Jarvis

Key Points

131

(1)

Introduction

132

(1)

Characteristics of Long-Term Care Facilities

132

(1)

Risk Factors for Outbreaks in LTCFs

133

(1)

Key Aspects of Infectious Disease Outbreak Investigation

134

(7)

Selected Infectious Disease Outbreaks

141

(4)

Conclusions

145

(1)

Suggested Reading

146

(1)

References

146

(3)

11. An Approach to Antimicrobial Therapy

149

(20)

Jay P. Rho

Key Points

149

(1)

General Issues of Antimicrobial Therapy

149

(2)

Optimizing the Use of Antimicrobial Agents in the LTCF

151

(4)

Drug Factors to Consider in Prescribing Antimicrobial Therapy

155

(4)

Potentially Useful and Safe Antimicrobial Agents for LTCF Residents

159

(5)

Suggested Reading

164

(1)

References

164

(5)

PART III: COMMON INFECTIONS IN LONG-TERM CARE FACILITIES

12. Urinary Tract Infection

169

(22)

Lindsay E. Nicolle

Key Points

169

(1)

Introduction

170

(1)

Epidemiology and Clinical Relevance

170

(5)

Clinical Manifestations

175

(2)

Diagnostic Approach

177

(3)

Therapeutic Interventions

180

(4)

Infection Control Measures

184

(1)

Prevention

185

(2)

Suggested Reading

187

(1)

References

187

(4)

13. Influenza and Other Respiratory Viruses

191

(24)

Ghinwa Dumyati

Key Points

191

(1)

Introduction

192

(1)

Influenza

192

(9)

Respiratory Syncytial Virus

201

(3)

Parainfluenza

204

(2)

Coronavirus

206

(2)

Rhinovirus

208

(1)

Human Metapneumovirus

209

(1)

Suggested Reading

210

(1)

References

210

(5)

14. Pneumonia and Bronchitis

215

(18)

Joseph M. Mylotte

Key Points

215

(1)

Nursing Home—Associated Pneumonia

215

(13)

Bronchitis

228

(1)

Suggested Reading

229

(1)

References

229

(4)

15. Tuberculosis

233

(18)

Shobita Rajagopalan

Key Points

233

(1)

Introduction

233

(1)

Epidemiology and Clinical Significance

234

(1)

Pathogenesis

235

(1)

Clinical Manifestations

236

(1)

Diagnosis

236

(1)

Treatment

237

(7)

Prevention

244

(1)

Infection Control

244

(3)

Suggested Reading

247

(1)

References

247

(4)

16. Infected Pressure Ulcers

251

(26)

Steven C. Reynolds and Anthony W. Chow

Key Points

251

(1)

Epidemiology and Clinical Relevance

252

(5)

Pathogenesis of Infected Pressure Ulcers

257

(1)

Clinical Manifestations

258

(1)

Diagnostic Approach

259

(5)

Therapeutic Interventions

264

(6)

Infection Control Measures

270

(2)

Prevention

272

(2)

Suggested Reading

274

(1)

References

274

(3)

17. Herpes Zoster, Cellulitis, and Scabies

277

(20)

Kenneth E. Schmader and Jack Twersky

Key Points

277

(1)

Herpes Zoster

278

(6)

Cellulitis

284

(6)

Scabies

290

(5)

Suggested Reading

295

(1)

References

295

(2)

18. Infectious Diarrhea

297

(14)

Abbasi Akhtar and Made Sutjita

Key Points

297

(1)

Epidemiology and Clinical Relevance

298

(2)

Clinical Manifestations

300

(1)

Diagnostic Approach

301

(4)

Therapeutic Intervention

305

(2)

Infection Control Measures

307

(1)

Prevention

308

(1)

Suggested Reading

308

(1)

References

308

(3)

19. Hepatitis in Long-Term Care Facilities

311

(24)

Darrell W. Harrington and Peter V. Barrett

Key Points

311

(1)

Introduction

311

(1)

Epidemiology and Clinical Relevance

312

(8)

Clinical Manifestations and Complications of Viral Hepatitis

320

(3)

Therapeutic Interventions

323

(3)

Infection Control and Prevention

326

(5)

Conclusion

331

(1)

Suggested Reading

332

(1)

References

332

(3)

20. Conjunctivitis, Otitis, and Sinusitis

335

(14)

Deborah Moran, Made Sutjita, and Kathleen Daretany

Key Points

335

(1)

Conjunctivitis

336

(2)

Otitis Media

338

(2)

Otitis Externa

340

(2)

Sinusitis

342

(3)

Suggested Reading

345

(1)

References

345

(4)

21. Human Immunodeficiency Virus Infection in the Nursing Home

349

(20)

Allen S. Funnyé

Key Points

349

(1)

Introduction

349

(1)

General Epidemiology

350

(2)

Epidemiology in Older Adults

352

(4)

Long-Term Care Facilities

356

(2)

Pathogenesis of HIV in the Elderly

358

(1)

Clinical Issues in Nursing Home AIDS Residents

359

(2)

Treatment of HIV Infection in the Nursing Home

361

(5)

Psychosocial Concerns and Prevention

366

(1)

Suggested Reading

367

(1)

References

367

(2)

22. Vaccinations

369

(22)

Rex Biedenbender, Stefan Gravenstein, and Arvydas Ambrozaitis

Key Points

369

(1)

Infection, Aging, and Immune Response

370

(1)

Vaccine Utilization in Long-Term Care Facilities

370

(1)

Efforts to Increase Vaccine Utilization

371

(1)

Influenza

371

(5)

Pneumococcal Disease

376

(10)

Varicella Vaccine

386

(1)

Vaccination of Health-Care Workers in LTCFs

387

(1)

Summary

387

(1)

Suggested Reading

388

(1)

References

388

(3)

PART IV: EMERGING AND DRUG-RESISTANT PATHOGENS

23. Methicillin-Resistant Staphylococcus aureus

391

(20)

Thomas T. Yoshikawa and Larry J. Strausbaugh

Key Points

391

(1)

Introduction

392

(1)

Epidemiology and Clinical Relevance

392

(4)

Clinical Manifestation

396

(2)

Diagnostic Approach

398

(1)

Therapeutic Interventions

399

(1)

Infection Control Measures

400

(6)

Prevention

406

(1)

Suggested Reading

406

(1)

References

407

(4)

24. Vancomycin (Glycopeptide)-Resistant Enterococci in the Long-Term Care Setting

411

(16)

Suzanne F. Bradley

Key Points

411

(1)

Epidemiology and Clinical Relevance

411

(4)

Clinical Manifestations

415

(1)

Diagnostic Approach

416

(2)

Therapeutic Interventions

418

(1)

Infection Control Measures

419

(4)

Prevention

423

(1)

Suggested Reading

424

(1)

References

424

(3)

25. Gram-Negative Bacteria

427

(18)

Vinod K. Dhawan

Key Points

427

(1)

Epidemiology and Clinical Relevance

428

(6)

Clinical Syndromes

434

(1)

Diagnostic Approach

434

(1)

Therapeutic Interventions

435

(4)

Prevention

439

(1)

Suggested Reading

440

(1)

References

440

(5)

26. Fungal Infections

445

(20)

Carol A. Kauffman and Sara A. Hedderwick

Key Points

445

(1)

Introduction

445

(1)

Epidemiology and Clinical Relevance

446

(2)

Clinical Manifestations

448

(4)

Diagnostic Approach

452

(3)

Therapeutic Interventions

455

(5)

Infection Control Measures

460

(1)

Prevention

461

(1)

Suggested Reading

462

(1)

References

462

(3)

27. Severe Acute Respiratory Syndrome

465

(8)

Mark B. Loeb

Key Points

465

(1)

Introduction

465

(1)

SARS: Epidemiology and Clinical Relevance

466

(1)

Microbiology

467

(1)

Clinical Disease

468

(1)

Diagnosis

469

(1)

Treatment

470

(1)

Prevention

471

(1)

Suggested Reading

471

(1)

References

471

PART V: IMPORTANT SOURCE REFERENCES

Appendix A: Definitions of Common Infections in Long-Term Care Facilities

473

(4)

Conditions Applicable to Definitions

473

(1)

Respiratory Tract Infection

473

(1)

Urinary Tract Infection

474

(1)

Skin Infections

475

(1)

Gastrointestinal Tract Infection

475

(1)

Comments

476

(1)

Appendix B: Guide to Evaluating Fever and Infection in Long-Term Care Facilities

477

(4)

Clinical Evaluation

477

(1)

Laboratory Tests

478

(2)

Indications for Transfer to an Acute Care Facility

480

(1)

Appendix C: Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term Care Facilities: Results of a Consensus Conference

481

(4)

Skin and Soft Tissue Infections

481

(1)

Respiratory Infections

481

(1)

Urinary Tract Infection

482

(1)

Fever in Which the Focus of Infection is Unknown

483

(2)

Index

485

(16)

About the Editors

501

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Infection Management for Geriatrics in Long-Term Care Facilities, Second Edition

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