Tract Infections In Residents Research Articles

Nursing Management-Associated Factors Associated with Urinary Tract Infection in Residents from Nursing Home Based on LTCfocus Database

Introduction: The aim of the study was to identify nursing management-associated factors correlated with urinary tract infection (UTI) in residents from nursing homes. Methods: The data of 3,393 nursing homes were extracted from LTCfocus database. Variables statistically correlated with UTI rate were identified by Spearman correlation analysis. Tobit regression model was used for finding the factors associated with UTI rate. Results: The number of beds (β = 0.03, 95% CI: 0.02–0.05), number of occupied beds/the total number of beds (β = 0.05, 95% CI: 0.03–0.07), number of admissions/total number of beds (β = 0.27, 95% CI: 0.11–0.43), the proportions of residents whose primary support is Medicare (β = 0.03, 95% CI: 0.01–0.06), women residents (β = 0.04, 95% CI: 0.02–0.06), White residents (β = 0.02, 95% CI: 0.01–0.03), patients with bladder incontinence (β = 0.03, 95% CI: 0.02–0.05), hypertension patients (β = 0.03, 95% CI: 0.01–0.05), and long-stay residents with daily pain (β = 0.16, 95% CI: 0.12–0.19), hospitalizations per resident year (β = 0.76, 95% CI: 0.30–1.21), and average daily census (β = −0.02, 95% CI: −0.03 to 0.00) were factors associated with UTI rate. Conclusions: Nursing homes with more females, White people, and patients with bladder incontinence, hypertension, or daily pain should be cared more and the number of occupied beds and admissions should be controlled to reduce the occurrence of UTI.

Microbial Aerosol Investigation and Health Risk Assessment of Residential Area in Wuhan City

In order to investigate the distribution and risk of microbial aerosols in residential areas after the COVID-19 in Wuhan Ctiy, Changqing Garden residential area, a mature community was selected as a case in this study. From October to December 2020, the Andersen-sixstage microbial air sampler was used to collect samples in six typical places in this residential area, and the microbial aerosol concentration was determined by the plate count method. In addition, the health risk assessment was evaluated according to the Chinese Population Exposure Parameters Manual (Adult Volume). The results showed that: (1) The concentration of microbial aerosol can be ranked in this order: fresh food market >underground parking lot >food street >central basketball court >central square >green pavilion. (2) The concentration of bacteria and fungus aerosol was different in different places, and the maximum aerosol concentration occurred in the fresh food market ((1525.32±1311.31) CFU/m3) and the food street ((1296.82±113.84) CFU/m3), respectively. (3) Take the air microbial concentration in typical places as the evaluation standard: the central basketball court, green pavilion and central square were clean, the fresh food market and underground parking lot were slightly polluted, and the food court was lightly pollution. (4) The median diameter of microbial aerosols was less than 4.7 μm, which can easily cause lower respiratory tract infections in residents. (5) The Hazard Quotient (HQ) of the typical places from October to December 2020 was less than 1, indicating that the health risk of microbial aerosol exposure in Changqing Garden residential area was relatively small. This research shows that the air quality of the Changqing Garden residential area is good under the epidemic prevention and control normalized measures, which meets the requirements for sanitary conditions in the post-COVID-19 era. © 2021, Editorial Board, Research of Environmental Sciences. All right reserved.

Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions.

A systematic review found that 3% of working adults who had received influenza vaccine and 5% of those who were unvaccinated had laboratory-proven influenza per season; in healthcare workers (HCWs) these percentages were 5% and 8% respectively. Healthcare workers may transmit influenza to patients. To identify all randomised controlled trials (RCTs) and non-RCTs assessing the effects of vaccinating healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs). We searched CENTRAL (2015, Issue 9), MEDLINE (1966 to October week 3, 2015), EMBASE (1974 to October 2015) and Web of Science (2006 to October 2015), but Biological Abstracts only from 1969 to March 2013 and Science Citation Index-Expanded from 1974 to March 2013 due to lack of institutional access in 2015. Randomised controlled trials (RCTs) and non-RCTs ofinfluenza vaccination of healthcare workers caring for individuals aged 60 years or older in LTCIs and the incidence of laboratory-proven influenza and its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 years or older in LTCIs. Two authors independently extracted data and assessed risk of bias. Effects on dichotomous outcomes were measured as risk differences (RDs) with 95% confidence intervals (CIs). We assessed the quality of evidence with GRADE. We identified four cluster-RCTs and one cohort study (n = 12,742) of influenza vaccination for HCWs caring for individuals ≥ 60 years in LTCIs. Four cluster RCTs (5896 residents) provided outcome data that addressed the objectives of our review. The studies were comparable in their study populations, intervention and outcome measures. The studies did not report adverse events. The principal sources of bias in the studies related to attrition, lack of blinding, contamination in the control groups and low rates of vaccination coverage in the intervention arms, leading us to downgrade the quality of evidence for all outcomes due to serious risk of bias.Offering influenza vaccination to HCWs based in long term care homes may have little or no effect on the number of residents who develop laboratory-proven influenza compared with those living in care homes where no vaccination is offered (RD 0 (95% CI -0.03 to 0.03), two studies with samples taken from 752 participants; low quality evidence). HCW vaccination probably leads to a reduction in lower respiratory tract infection in residents from 6% to 4% (RD -0.02 (95% CI -0.04 to 0.01), one study of 3400 people; moderate quality evidence). HCW vaccination programmes may have little or no effect on the number of residents admitted to hospital for respiratory illness (RD 0 (95% CI -0.02 to 0.02, one study of 1059 people; low quality evidence). We decided not to combine data on deaths from lower respiratory tract infection (two studies of 4459 people) or all cause deaths (four studies of 8468 people). The direction and size of difference in risk varied between the studies. We are uncertain as to the effect of vaccination on these outcomes due to the very low quality of evidence. Adjusted analyses, which took into account the cluster design, did not differ substantively from the pooled analysis with unadjusted data. Our review findings have not identified conclusive evidence of benefit of HCW vaccination programmes on specific outcomes of laboratory-proven influenza, its complications (lower respiratory tract infection, hospitalisation or death due to lower respiratory tract illness), or all cause mortality in people over the age of 60 who live in care institutions. This review did not find information on co-interventions with healthcare worker vaccination: hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding admissions, antivirals and asking healthcare workers with influenza or influenza-like illness (ILI) not to work. This review does not provide reasonable evidence to support the vaccination of healthcare workers to prevent influenza in those aged 60 years or older resident in LTCIs. High quality RCTs are required to avoid the risks of bias in methodology and conduct identified by this review and to test further these interventions in combination.

Prevalence of acute respiratory infection and knowledge,attitude and practice(KAP) associated with influenza in Shenzhen and Zhengzhou city——a telephone survey

Objective To explore the prevalence of acute respiratory tract infection in residents of Shenzhen and Zhengzhou city in different pandemic stages and the knowledge,attitude and practice of influenza A (H1N1).Methods The telephone survey with periodical-probability proportion to size sampling was conducted.Results The rates of acute respiratory infection in the participants and their families were 10.1% and 6.1% in Shenzhen and 5.6% and 3.0% in Zhengzhou.There were 10.9% and 9.2% of participants reporting ordinary flu and influenza A vaccination in Shenzhen and the rates were lower than those of in Zhengzhou.There were 62.2% of participants knowing the free vaccine strategy of influenza A(H1N1) in Shenzhen and 67.5% in Zhengzhou.Conclusion The prevalences of acute respiratory infection and influenza A(H1N1) vaccinatian were higher in residents of Shenzhen city compared to those of Zhengzhou and the health education on influeaza A is needed for the residents of the two cities.

Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial

Objective To assess whether a multifaceted intervention can reduce the number of prescriptions for antimicrobials for suspected urinary tract infections in residents of nursing homes.Design Cluster randomised controlled trial.Setting 24...

A Comparison of Model-Building Strategies for Lower Respiratory Tract Infection in Long-Term Care

Five strategies for creating predictive models of lower respiratory tract infection in residents of long-term care facilities were compared. A linear judgment model was derived by administering clinical vignettes to physicians who indicated the risk of infection based on the presence or absence of five predictor variables. A model based on physician consensus was created using the same variables. Three models based on empirical data (logistic regression, proportional hazards, and recursive partitioning) were created from a “derivation” sample of data from a cohort study of lower respiratory tract infections in nursing homes using the five predictor variables. All models were applied to a validation set and compared using receiver operating characteristic (ROC) curves. The data-derived and consensus models showed the highest discriminative ability while the linear judgment model showed inferior performance.

Serological study of responses to selected pathogens causing respiratory tract infection in the institutionalized elderly.

In a prospective 2-year study, serological responses to selected pathogens were analyzed in 224 episodes of fever attributable to respiratory tract infection (51.8%) or of unknown source (48.2%) in 131 residents of two long-term-care facilities. A serological response was identified in 45 episodes (20.1%): Chlamydia pneumoniae (14 episodes), Haemophilus influenzae type b (1), influenza virus type A (14), respiratory syncytial virus (RSV;2), parainfluenza virus type 3 (7), C. pneumoniae and H. influenzae (3), C. pneumoniae and influenza virus type A (2), C. pneumoniae and RSV (1), and C. pneumoniae and parainfluenza virus type 3 (1). No serological responses to Chlamydia psittaci, Chlamydia trachomatis, parainfluenza virus types 1 and 2, influenza virus type B, or Mycoplasma pneumoniae were seen. Vaccination did not affect the duration of fever in those residents with serologically confirmed influenza A. Serologically confirmed C. pneumoniae infection was detected in 9.4% of all febrile episodes. Serological responses to a second agent were detected in 33% of the patients with C. pneumoniae infections, and these dual infections were associated with an underlying malignancy (P = .02). C. pneumoniae should be recognized as a potential pathogen when choosing empirical antimicrobial therapy for respiratory tract infection in residents of long-term-care facilities.