Abstract
Diarrhea is a common problem in nursing homes. A survey among nursing facilities in Poland was used to characterize diarrhea outbreaks, the burden caused for residents and caregivers and the employed measures. Survey results confirmed that diarrhea is a common problem in nursing homes and in most cases affects groups of residents. The related burden is high or very high for 27% of residents and 40% of caregivers. In 80% of nursing facilities pro or synbiotics are part of the measures used to manage diarrhea. Administration of these kinds of products has been suggested for the management of diarrhea, especially in cases caused by Clostridioides (C.) difficile. C. difficile is one of many potential causes for diarrhea, but is of particular concern for nursing homes because it is responsible for a large proportion of diarrhea outbreaks and is often caused by multi-drug resistant strains. In vitro inhibition of a quinolone-resistant and a multi-drug resistant C. difficile strain was used to evaluate the growth inhibitory effects of commonly used products containing probiotic microorganisms. Growth of both strains was best inhibited by multi-strain synbiotic preparations. These findings suggest that multi-strain synbiotics can be considered as an interventional option for diarrhea caused by C. difficile.
Highlights
Diarrhea is commonly accepted as a problem in nursing home facilities for the elderly, but few studies have evaluated its characteristics and how it is managed in daily practice
One of the surveys did not specify the average age of the residents and three missed the estimate for the number of residents affected by diarrhea at least once during a year
Missed the estimate for the number of residents affected by diarrhea at least once dur a year
Summary
Diarrhea is commonly accepted as a problem in nursing home facilities for the elderly, but few studies have evaluated its characteristics and how it is managed in daily practice.The present study employed a simple and easy to answer survey among heads of nursing staff of Polish nursing facilities for the elderly to collect information about: (i) occurrence rates and characteristics of diarrheal disease, (ii) the burden caused by diarrhea for residents and caregivers and (iii) the measures which are employed to manage diarrhea. Diarrhea is commonly accepted as a problem in nursing home facilities for the elderly, but few studies have evaluated its characteristics and how it is managed in daily practice. The survey results indicated a surprisingly high (80%) utilization rate of probiotics or synbiotics for the management of diarrhea in nursing facilities. Based on this finding the study was extended to include an experimental part, aimed to characterize the effects of probiotics and synbiotics on the in vitro growth of C. difficile. C. difficile infection (CDI) is one of many possible reasons for diarrhea outbreaks in nursing home facilities for the elderly. In quantitative terms it is responsible for a large share of these outbreaks [1,2]
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