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

by Yoshikawa; Thomas T.

• ISBN13: 9780849398933
• ISBN10: 0849398932
• Edition: 2nd
• Format: Hardcover
• Copyright: 2006-09-14
• Publisher: CRC Press

Summary

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.

Table of Contents

Preface to the Second Edition	v
Preface to the First Edition	vii
Acknowledgment	xi
Contributors	xxv
PART I: PRINCIPLES OF AGING, LONG-TERM CARE, AND INFECTION
1. Demographics and Economics of Long-Term Care	1	(14)
A. Jefferson Lesesne and Joseph G. Ouslander
Key Points	1	(1)
Introduction	2	(1)
Demand for Nursing Facility Care	2	(6)
Economics of LTC	8	(3)
Evolving Changes in LTC	11	(1)
References	12	(3)
2. Epidemiology and Special Aspects of Infectious Diseases in Aging	15	(6)
Thomas T. Yoshikawa
Key Points	15	(1)
Conceptual Basis for Importance of Infection and Aging	15	(2)
Special Aspects of Infections in the Elderly	17	(2)
Suggested Reading	19	(1)
References	19	(2)
3. Evaluation of Infections in Long-Term Care Facilities Versus Acute Care Hospitals	21	(10)
Arnel M. Joaquin
Key Points	21	(1)
Introduction	21	(4)
When to Transfer Long-Term Care Facilities Residents to an Acute Care Setting	25	(2)
Summary	27	(1)
Suggested Reading	27	(1)
References	28	(3)
4. Role of Functional Assessment in Evaluating and Managing Infections in Long-Term Care	31	(18)
Barbara J. Messinger-Rapport and Robert M. Palmer
Key Points	31	(1)
Introduction	32	(5)
Importance of Functional Assessment During Transitions of Care	37	(5)
Functional Assessment in LTC	42	(1)
Process of Functional Assessment	43	(3)
Infection Control and Function	46	(1)
Summary	46	(1)
Suggested Reading	47	(1)
References	47	(2)
5. Impaired Immunity and Increased Risk of Infections in Older Adults: Impact of Chronic Disease on Immunosenescence	49	(22)
Steven C. Castle, Koichi Uyemura, and Takashi Makinodan
Key Points	49	(1)
Introduction	50	(1)
Immunosenescence	50	(7)
Impaired Immunity Due to the Impact of Chronic Illness on an Aging Immune System (Immunosenescence)	57	(2)
Inflammatory Mediators and Immunity	59	(3)
Impact of Age and Chronic Illness–Related Impaired Immunity on Infections	62	(4)
Concluding Remarks	66	(1)
Suggested Reading	67	(1)
References	68	(3)
6. Nutrition and Infection	71	(16)
Kevin P. High
Key Points	71	(1)
Introduction	72	(1)
Prevalence and Causes of Malnutrition in Older Residents of LTCFs	72	(3)
Assessment of Nutritional Status and Consequences of Malnutrition in Long-Term Care Residents	75	(2)
Nutritional Interventions to Reduce Infection and Improve Outcomes in LTCF Residents	77	(2)
Specific Syndromes Where Nutritional Supplementation May Be of Benefit	79	(3)
Drug–Nutrient Interactions	82	(1)
Conclusions	82	(2)
Suggested Reading	84	(1)
References	84	(3)
7. Ethical Issues of Infectious Disease Interventions	87	(18)
Elizabeth L. Cobbs
Key Points	87	(1)
Introduction	87	(1)
Elements of Ethics	88	(2)
Everyday Ethics	90	(1)
The Doctor–Patient Relationship	91	(1)
Goals of Care and Advance Care Plans	91	(1)
Interventions: Burdens and Benefits	92	(1)
Quality of Life	93	(1)
Health Promotion	94	(1)
Health-Care Decision Making	94	(3)
Role of the Interdisciplinary Team	97	(1)
Role of the Medical Director	98	(1)
Advanced Dementia	98	(1)
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome	99	(1)
End-of-Life Care	99	(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