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J Am Geriatr Soc. 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.

Infectious Diseases in Older Adults of Long-Term Care Facilities: Update on Approach to Diagnosis and Management.

Jump RLP1,2,3, Crnich CJ4,5,6, Mody L7,8, Bradley SF9,10, Nicolle LE11,12, Yoshikawa TT13,14,15.

Author information

1
Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio.
2
Specialty Care Center of Innovation, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio.
3
Division of Infectious Diseases and HIV Medicine, Department of Medicine and Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio.
4
School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
5
William S. Middleton Veterans Affairs Medical Center, Madison, Wisconsin.
6
University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
7
Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
8
Division of Geriatric and Palliative Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.
9
Division of Infectious Diseases, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
10
School of Medicine, University of Michigan, Ann Arbor, Michigan.
11
Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Winnepeg, Manitoba, Canada.
12
Department of Medical Microbiology, Health Sciences Centre, University of Manitoba, Winnepeg, Manitoba, Canada.
13
Geriatric and Extended Care Service, Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
14
Department of Medicine, Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
15
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.

Abstract

The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting.

KEYWORDS:

geriatrics; infections; infectious diseases; long-term care facilities; nursing facilities; nursing homes

PMID:
29667186
PMCID:
PMC5909836
DOI:
10.1111/jgs.15248
[Indexed for MEDLINE]
Free PMC Article

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