Skip to main content
Clinical Microbiology Reviews logoLink to Clinical Microbiology Reviews
. 1996 Jan;9(1):1–17. doi: 10.1128/cmr.9.1.1

Infections and antibiotic resistance in nursing homes.

L E Nicolle 1, L J Strausbaugh 1, R A Garibaldi 1
PMCID: PMC172878  PMID: 8665472

Abstract

Infections occur frequently in nursing home residents. The most common infections are pneumonia, urinary tract infection, and skin and soft tissue infection. Aging-associated physiologic and pathologic changes, functional disability, institutionalization, and invasive devices all contribute to the high occurrence of infection. Antimicrobial agent use in nursing homes is intense and usually empiric. All of these factors contribute to the increasing frequency of antimicrobial agent-resistant organisms in nursing homes. Programs that will limit the emergence and impact of antimicrobial resistance and infections in nursing homes need to be developed.

Full Text

The Full Text of this article is available as a PDF (279.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Addiss D. G., Davis J. P., Meade B. D., Burstyn D. G., Meissner M., Zastrow J. A., Berg J. L., Drinka P., Phillips R. A pertussis outbreak in a Wisconsin nursing home. J Infect Dis. 1991 Oct;164(4):704–710. doi: 10.1093/infdis/164.4.704. [DOI] [PubMed] [Google Scholar]
  2. Aeilts G. D., Sapico F. L., Canawati H. N., Malik G. M., Montgomerie J. Z. Methicillin-resistant-Staphylococcus aureus colonization and infection in a rehabilitation facility. J Clin Microbiol. 1982 Aug;16(2):218–223. doi: 10.1128/jcm.16.2.218-223.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Agius G., Dindinaud G., Biggar R. J., Peyre R., Vaillant V., Ranger S., Poupet J. Y., Cisse M. F., Castets M. An epidemic of respiratory syncytial virus in elderly people: clinical and serological findings. J Med Virol. 1990 Feb;30(2):117–127. doi: 10.1002/jmv.1890300208. [DOI] [PubMed] [Google Scholar]
  4. Alling B., Brandberg A., Seeberg S., Svanborg A. Aerobic and anaerobic microbial flora in the urinary tract of geriatric patients during long-term care. J Infect Dis. 1973 Jan;127(1):34–39. doi: 10.1093/infdis/127.1.34. [DOI] [PubMed] [Google Scholar]
  5. Allman R. M. Pressure ulcers among the elderly. N Engl J Med. 1989 Mar 30;320(13):850–853. doi: 10.1056/NEJM198903303201307. [DOI] [PubMed] [Google Scholar]
  6. Alvarez S., Shell C. G., Woolley T. W., Berk S. L., Smith J. K. Nosocomial infections in long-term facilities. J Gerontol. 1988 Jan;43(1):M9–17. doi: 10.1093/geronj/43.1.m9. [DOI] [PubMed] [Google Scholar]
  7. Arroyo J. C., Postic B., Brown A., Harrison K., Birgenheier R., Dowda H. Influenza A/Philippines/2/82 outbreak in a nursing home: limitations of influenza vaccination in the aged. Am J Infect Control. 1984 Dec;12(6):329–334. doi: 10.1016/0196-6553(84)90005-1. [DOI] [PubMed] [Google Scholar]
  8. Auerbach S. B., Schwartz B., Williams D., Fiorilli M. G., Adimora A. A., Breiman R. F., Jarvis W. R. Outbreak of invasive group A streptococcal infections in a nursing home. Lessons on prevention and control. Arch Intern Med. 1992 May;152(5):1017–1022. [PubMed] [Google Scholar]
  9. Baine W. B., Gangarosa E. J., Bennett J. V., Barker W. H., Jr Institutional salmonellosis. J Infect Dis. 1973 Sep;128(3):357–360. doi: 10.1093/infdis/128.3.357. [DOI] [PubMed] [Google Scholar]
  10. Beers M., Avorn J., Soumerai S. B., Everitt D. E., Sherman D. S., Salem S. Psychoactive medication use in intermediate-care facility residents. JAMA. 1988 Nov 25;260(20):3016–3020. [PubMed] [Google Scholar]
  11. Ben-Yehuda A., Weksler M. E. Host resistance and the immune system. Clin Geriatr Med. 1992 Nov;8(4):701–711. [PubMed] [Google Scholar]
  12. Bentley D. W. Bacterial pneumonia in the elderly: clinical features, diagnosis, etiology, and treatment. Gerontology. 1984;30(5):297–307. doi: 10.1159/000212649. [DOI] [PubMed] [Google Scholar]
  13. Bentley D. W. Clostridium difficile-associated disease in long-term care facilities. Infect Control Hosp Epidemiol. 1990 Aug;11(8):434–438. doi: 10.1086/646204. [DOI] [PubMed] [Google Scholar]
  14. Bentley D. W. Tuberculosis in long-term care facilities. Infect Control Hosp Epidemiol. 1990 Jan;11(1):42–46. doi: 10.1086/646077. [DOI] [PubMed] [Google Scholar]
  15. Berlowitz D. R., Wilking S. V. Risk factors for pressure sores. A comparison of cross-sectional and cohort-derived data. J Am Geriatr Soc. 1989 Nov;37(11):1043–1050. doi: 10.1111/j.1532-5415.1989.tb06918.x. [DOI] [PubMed] [Google Scholar]
  16. Bjork D. T., Pelletier L. L., Tight R. R. Urinary tract infections with antibiotic resistant organisms in catheterized nursing home patients. Infect Control. 1984 Apr;5(4):173–176. doi: 10.1017/s0195941700059178. [DOI] [PubMed] [Google Scholar]
  17. Bloom H. G., Bottone E. J. Aeromonas hydrophila diarrhea in a long-term care setting. J Am Geriatr Soc. 1990 Jul;38(7):804–806. doi: 10.1111/j.1532-5415.1990.tb01473.x. [DOI] [PubMed] [Google Scholar]
  18. Boustcha E., Nicolle L. E. Conjunctivitis in a long-term care facility. Infect Control Hosp Epidemiol. 1995 Apr;16(4):210–216. doi: 10.1086/647092. [DOI] [PubMed] [Google Scholar]
  19. Boyce J. M., Jackson M. M., Pugliese G., Batt M. D., Fleming D., Garner J. S., Hartstein A. I., Kauffman C. A., Simmons M., Weinstein R. Methicillin-resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. The AHA Technical Panel on Infections Within Hospitals. Infect Control Hosp Epidemiol. 1994 Feb;15(2):105–115. doi: 10.1086/646870. [DOI] [PubMed] [Google Scholar]
  20. Bradley S. F., Terpenning M. S., Ramsey M. A., Zarins L. T., Jorgensen K. A., Sottile W. S., Schaberg D. R., Kauffman C. A. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med. 1991 Sep 15;115(6):417–422. doi: 10.7326/0003-4819-115-6-417. [DOI] [PubMed] [Google Scholar]
  21. Brandeis G. H., Morris J. N., Nash D. J., Lipsitz L. A. The epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA. 1990 Dec 12;264(22):2905–2909. [PubMed] [Google Scholar]
  22. Brennen C., Muder R. R. Conjunctivitis associated with methicillin-resistant Staphylococcus aureus in a long-term-care facility. Am J Med. 1990 May;88(5N):14N–17N. [PubMed] [Google Scholar]
  23. Brennen C., Muder R. R., Muraca P. W. Occult endemic tuberculosis in a chronic care facility. Infect Control Hosp Epidemiol. 1988 Dec;9(12):548–552. doi: 10.1086/645774. [DOI] [PubMed] [Google Scholar]
  24. Brocklehurst J. C., Bee P., Jones D., Palmer M. K. Bacteriuria in geriatric hospital patients its correlates and management. Age Ageing. 1977 Nov;6(4):240–245. doi: 10.1093/ageing/6.4.240. [DOI] [PubMed] [Google Scholar]
  25. Budnick L. D., Schaefler S. Ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus in New York health care facilities, 1988. The New York MRSA Study Group. Am J Public Health. 1990 Jul;80(7):810–813. doi: 10.2105/ajph.80.7.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Campbell B. Surveillance and control of infections in long-term care: the Canadian experience. Am J Med. 1991 Sep 16;91(3B):286S–288S. doi: 10.1016/0002-9343(91)90383-9. [DOI] [PubMed] [Google Scholar]
  27. Carter A. O., Borczyk A. A., Carlson J. A., Harvey B., Hockin J. C., Karmali M. A., Krishnan C., Korn D. A., Lior H. A severe outbreak of Escherichia coli O157:H7--associated hemorrhagic colitis in a nursing home. N Engl J Med. 1987 Dec 10;317(24):1496–1500. doi: 10.1056/NEJM198712103172403. [DOI] [PubMed] [Google Scholar]
  28. Castle S. C., Norman D. C., Yeh M., Miller D., Yoshikawa T. T. Fever response in elderly nursing home residents: are the older truly colder? J Am Geriatr Soc. 1991 Sep;39(9):853–857. doi: 10.1111/j.1532-5415.1991.tb04450.x. [DOI] [PubMed] [Google Scholar]
  29. Cederna J. E., Terpenning M. S., Ensberg M., Bradley S. F., Kauffman C. A. Staphylococcus aureus nasal colonization in a nursing home: eradication with mupirocin. Infect Control Hosp Epidemiol. 1990 Jan;11(1):13–16. doi: 10.1086/646072. [DOI] [PubMed] [Google Scholar]
  30. Cesario T. C., Yousefi S. Viral infections. Clin Geriatr Med. 1992 Nov;8(4):735–743. [PubMed] [Google Scholar]
  31. Choi M., Yoshikawa T. T., Bridge J., Schlaifer A., Osterweil D., Reid D., Norman D. C. Salmonella outbreak in a nursing home. J Am Geriatr Soc. 1990 May;38(5):531–534. doi: 10.1111/j.1532-5415.1990.tb02403.x. [DOI] [PubMed] [Google Scholar]
  32. Christie R. W., Marquis L. L. Immunization roulette: influenza occurrence in five nursing homes. Am J Infect Control. 1985 Aug;13(4):174–177. doi: 10.1016/0196-6553(85)90104-x. [DOI] [PubMed] [Google Scholar]
  33. Ciocon J. O., Silverstone F. A., Graver L. M., Foley C. J. Tube feedings in elderly patients. Indications, benefits, and complications. Arch Intern Med. 1988 Feb;148(2):429–433. [PubMed] [Google Scholar]
  34. Cohen E. D., Hierholzer W. J., Jr, Schilling C. R., Snydman D. R. Nosocomial infections in skilled nursing facilities: a preliminary survey. Public Health Rep. 1979 Mar-Apr;94(2):162–165. [PMC free article] [PubMed] [Google Scholar]
  35. Cohn J. R., Hohl C. A., Buckley C. E., 3rd The relationship between cutaneous cellular immune responsiveness and mortality in a nursing home population. J Am Geriatr Soc. 1983 Dec;31(12):808–809. doi: 10.1111/j.1532-5415.1983.tb03404.x. [DOI] [PubMed] [Google Scholar]
  36. Crossley K. B., Irvine P., Kaszar D. J., Loewenson R. B. Infection control practices in Minnesota nursing homes. JAMA. 1985 Nov 22;254(20):2918–2921. [PubMed] [Google Scholar]
  37. Crossley K., Henry K., Irvine P., Willenbring K. Antibiotic use in nursing homes: prevalence, cost and utilization review. Bull N Y Acad Med. 1987 Jul-Aug;63(6):510–518. [PMC free article] [PubMed] [Google Scholar]
  38. Daly P. B., Smith P. W., Rusnak P. G., Jones M. B., Giuliano D. Impact on knowledge and practice of a multiregional long-term care facility infection control training program. Am J Infect Control. 1992 Oct;20(5):225–233. doi: 10.1016/s0196-6553(05)80195-6. [DOI] [PubMed] [Google Scholar]
  39. Darnowski S. B., Gordon M., Simor A. E. Two years of infection surveillance in a geriatric long-term care facility. Am J Infect Control. 1991 Aug;19(4):185–190. doi: 10.1016/0196-6553(91)90002-t. [DOI] [PubMed] [Google Scholar]
  40. Degelau J. Scabies in long-term care facilities. Infect Control Hosp Epidemiol. 1992 Jul;13(7):421–425. doi: 10.1086/646561. [DOI] [PubMed] [Google Scholar]
  41. Downton J. H., Andrews K., Puxty J. A. 'Silent' pyrexia in the elderly. Age Ageing. 1987 Jan;16(1):41–44. doi: 10.1093/ageing/16.1.41. [DOI] [PubMed] [Google Scholar]
  42. Falsey A. R. Noninfluenza respiratory virus infection in long-term care facilities. Infect Control Hosp Epidemiol. 1991 Oct;12(10):602–608. doi: 10.1086/646249. [DOI] [PubMed] [Google Scholar]
  43. Farber B. F., Brennen C., Puntereri A. J., Brody J. P. A prospective study of nosocomial infections in a chronic care facility. J Am Geriatr Soc. 1984 Jul;32(7):499–502. doi: 10.1111/j.1532-5415.1984.tb02234.x. [DOI] [PubMed] [Google Scholar]
  44. Fay D. E., Poplausky M., Gruber M., Lance P. Long-term enteral feeding: a retrospective comparison of delivery via percutaneous endoscopic gastrostomy and nasoenteric tubes. Am J Gastroenterol. 1991 Nov;86(11):1604–1609. [PubMed] [Google Scholar]
  45. Fierer J., Ekstrom M. An outbreak of Providencia stuartii urinary tract infections. Patients with condom catheters are a reservoir of the bacteria. JAMA. 1981 Apr 17;245(15):1553–1555. [PubMed] [Google Scholar]
  46. Flournoy D. J. Antimicrobial susceptibilities of bacteria from nursing home residents in Oklahoma. Gerontology. 1994;40(1):53–56. doi: 10.1159/000213575. [DOI] [PubMed] [Google Scholar]
  47. Franson T. R., Duthie E. H., Jr, Cooper J. E., Van Oudenhoven G., Hoffmann R. G. Prevalence survey of infections and their predisposing factors at a hospital-based nursing home care unit. J Am Geriatr Soc. 1986 Feb;34(2):95–100. doi: 10.1111/j.1532-5415.1986.tb05475.x. [DOI] [PubMed] [Google Scholar]
  48. Freedland C. P., Roller R. D., Wolfe B. M., Flynn N. M. Microbial contamination of continuous drip feedings. JPEN J Parenter Enteral Nutr. 1989 Jan-Feb;13(1):18–22. doi: 10.1177/014860718901300118. [DOI] [PubMed] [Google Scholar]
  49. Garb J. L., Brown R. B., Garb J. R., Tuthill R. W. Differences in etiology of pneumonias in nursing home and community patients. JAMA. 1978 Nov 10;240(20):2169–2172. [PubMed] [Google Scholar]
  50. Garibaldi R. A., Brodine S., Matsumiya S. Infections among patients in nursing homes: policies, prevalence, problems. N Engl J Med. 1981 Sep 24;305(13):731–735. doi: 10.1056/NEJM198109243051304. [DOI] [PubMed] [Google Scholar]
  51. Gaynes R. P., Weinstein R. A., Chamberlin W., Kabins S. A. Antibiotic-resistant flora in nursing home patients admitted to the hospital. Arch Intern Med. 1985 Oct;145(10):1804–1807. [PubMed] [Google Scholar]
  52. Gellert G. A., Waterman S. H., Ewert D., Oshiro L., Giles M. P., Monroe S. S., Gorelkin L., Glass R. I. An outbreak of acute gastroenteritis caused by a small round structured virus in a geriatric convalescent facility. Infect Control Hosp Epidemiol. 1990 Sep;11(9):459–464. doi: 10.1086/646212. [DOI] [PubMed] [Google Scholar]
  53. Gerding D. N., Buxton A. E., Hughes R. A., Cleary P. P., Arbaczawski J., Stamm W. E. Nosocomial multiply resistant Klebsiella pneumoniae: epidemiology of an outbreak of apparent index case origin. Antimicrob Agents Chemother. 1979 Apr;15(4):608–615. doi: 10.1128/aac.15.4.608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Gleckman R., Hibert D. Afebrile bacteremia. A phenomenon in geriatric patients. JAMA. 1982 Sep 24;248(12):1478–1481. doi: 10.1001/jama.248.12.1478. [DOI] [PubMed] [Google Scholar]
  55. Goodman R. A., Orenstein W. A., Munro T. F., Smith S. C., Sikes R. K. Impact of influenza A in a nursing home. JAMA. 1982 Mar 12;247(10):1451–1453. [PubMed] [Google Scholar]
  56. Gordon W. Z., Kane R. L., Rothenberg R. Acute hospitalization in a home for the aged. J Am Geriatr Soc. 1985 Aug;33(8):519–523. doi: 10.1111/j.1532-5415.1985.tb04614.x. [DOI] [PubMed] [Google Scholar]
  57. Gravenstein S., Miller B. A., Drinka P. Prevention and control of influenza A outbreaks in long-term care facilities. Infect Control Hosp Epidemiol. 1992 Jan;13(1):49–54. doi: 10.1086/646422. [DOI] [PubMed] [Google Scholar]
  58. Gross J. S., Neufeld R. R., Libow L. S., Gerber I., Rodstein M. Autopsy study of the elderly institutionalized patient. Review of 234 autopsies. Arch Intern Med. 1988 Jan;148(1):173–176. [PubMed] [Google Scholar]
  59. Grunow J. E., Christenson J. C., Moutos D. Contamination of enteral nutrition systems during prolonged intermittent use. JPEN J Parenter Enteral Nutr. 1989 Jan-Feb;13(1):23–25. doi: 10.1177/014860718901300123. [DOI] [PubMed] [Google Scholar]
  60. Harkness G. A., Bentley D. W., Mottley M., Lee J. Streptococcus pyogenes outbreak in a long-term care facility. Am J Infect Control. 1992 Jun;20(3):142–148. doi: 10.1016/s0196-6553(05)80181-6. [DOI] [PubMed] [Google Scholar]
  61. Harper C., Newton P. Clinical aspects of pneumonia in the elderly veteran. J Am Geriatr Soc. 1989 Sep;37(9):867–872. doi: 10.1111/j.1532-5415.1989.tb02268.x. [DOI] [PubMed] [Google Scholar]
  62. Henderson C. T. Nutrition and malnutrition in the elderly nursing home patient. Clin Geriatr Med. 1988 Aug;4(3):527–547. [PubMed] [Google Scholar]
  63. Hoffman N., Jenkins R., Putney K. Nosocomial infection rates during a one-year period in a nursing home care unit of a Veterans Administration hospital. Am J Infect Control. 1990 Apr;18(2):55–63. doi: 10.1016/0196-6553(90)90082-4. [DOI] [PubMed] [Google Scholar]
  64. Horman J. T., Stetler H. C., Israel E., Sorley D., Schipper M. T., Joseph J. M. An outbreak of influenza A in a nursing home. Am J Public Health. 1986 May;76(5):501–504. doi: 10.2105/ajph.76.5.501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Hsu C. C. Serial survey of methicillin-resistant Staphylococcus aureus nasal carriage among residents in a nursing home. Infect Control Hosp Epidemiol. 1991 Jul;12(7):416–421. doi: 10.1086/646371. [DOI] [PubMed] [Google Scholar]
  66. Irvine P. W., Van Buren N., Crossley K. Causes for hospitalization of nursing home residents: the role of infection. J Am Geriatr Soc. 1984 Feb;32(2):103–107. doi: 10.1111/j.1532-5415.1984.tb05848.x. [DOI] [PubMed] [Google Scholar]
  67. Irwin R. S., Whitaker S., Pratter M. R., Millard C. E., Tarpey J. T., Corwin R. W. The transiency of oropharyngeal colonization with gram-negative bacilli in residents of a skilled nursing facility. Chest. 1982 Jan;81(1):31–35. doi: 10.1378/chest.81.1.31. [DOI] [PubMed] [Google Scholar]
  68. Jackson M. M., Fierer J., Barrett-Connor E., Fraser D., Klauber M. R., Hatch R., Burkhart B., Jones M. Intensive surveillance for infections in a three-year study of nursing home patients. Am J Epidemiol. 1992 Mar 15;135(6):685–696. doi: 10.1093/oxfordjournals.aje.a116348. [DOI] [PubMed] [Google Scholar]
  69. Jackson M. M., Fierer J. Infections and infection risk in residents of long-term care facilities: a review of the literature, 1970-1984. Am J Infect Control. 1985 Apr;13(2):63–77. doi: 10.1016/0196-6553(85)90084-7. [DOI] [PubMed] [Google Scholar]
  70. Jacobson C., Strausbaugh L. J. Incidence and impact of infection in a nursing home care unit. Am J Infect Control. 1990 Jun;18(3):151–159. doi: 10.1016/0196-6553(90)90180-z. [DOI] [PubMed] [Google Scholar]
  71. John J. F., Jr, Ribner B. S. Antibiotic resistance in long-term care facilities. Infect Control Hosp Epidemiol. 1991 Apr;12(4):245–250. doi: 10.1086/646332. [DOI] [PubMed] [Google Scholar]
  72. Johnson E. T. The condom catheter: urinary tract infection and other complications. South Med J. 1983 May;76(5):579–582. [PubMed] [Google Scholar]
  73. Jones S. R., Parker D. F., Liebow E. S., Kimbrough R. C., 3rd, Frear R. S. Appropriateness of antibiotic therapy in long-term care facilities. Am J Med. 1987 Sep;83(3):499–502. doi: 10.1016/0002-9343(87)90761-3. [DOI] [PubMed] [Google Scholar]
  74. Katz P. R., Beam T. R., Jr, Brand F., Boyce K. Antibiotic use in the nursing home. Physician practice patterns. Arch Intern Med. 1990 Jul;150(7):1465–1468. [PubMed] [Google Scholar]
  75. Kemper P., Murtaugh C. M. Lifetime use of nursing home care. N Engl J Med. 1991 Feb 28;324(9):595–600. doi: 10.1056/NEJM199102283240905. [DOI] [PubMed] [Google Scholar]
  76. Kerr H. D., Byrd J. C. Nursing home patients transferred by ambulance to a VA emergency department. J Am Geriatr Soc. 1991 Feb;39(2):132–136. doi: 10.1111/j.1532-5415.1991.tb01614.x. [DOI] [PubMed] [Google Scholar]
  77. Khabbaz R. F., Tenney J. H. Infection control in Maryland nursing homes. Infect Control Hosp Epidemiol. 1988 Apr;9(4):159–162. doi: 10.1086/645821. [DOI] [PubMed] [Google Scholar]
  78. Larson E., Bobo L., Bennett R., Murphy S., Seng S. T., Choo J. T., Sisler J. Lack of care giver hand contamination with endemic bacterial pathogens in a nursing home. Am J Infect Control. 1992 Feb;20(1):11–15. doi: 10.1016/s0196-6553(05)80118-x. [DOI] [PubMed] [Google Scholar]
  79. Lee Y. L., Cesario T., Lee R., Nothvogel S., Nassar J., Farsad N., Thrupp L. Colonization by Staphylococcus species resistant to methicillin or quinolone on hands of medical personnel in a skilled-nursing facility. Am J Infect Control. 1994 Dec;22(6):346–351. doi: 10.1016/0196-6553(94)90033-7. [DOI] [PubMed] [Google Scholar]
  80. Lee Y. L., Thrupp L. D., Friis R. H., Fine M., Maleki P., Cesario T. C. Nosocomial infection and antibiotic utilization in geriatric patients: a pilot prospective surveillance program in skilled nursing facilities. Gerontology. 1992;38(4):223–232. doi: 10.1159/000213332. [DOI] [PubMed] [Google Scholar]
  81. Levine W. C., Smart J. F., Archer D. L., Bean N. H., Tauxe R. V. Foodborne disease outbreaks in nursing homes, 1975 through 1987. JAMA. 1991 Oct 16;266(15):2105–2109. [PubMed] [Google Scholar]
  82. MacArthur R. D., Lehman M. H., Currie-McCumber C. A., Shlaes D. M. The epidemiology of gentamicin-resistant Pseudomonas aeruginosa on an intermediate care unit. Am J Epidemiol. 1988 Oct;128(4):821–827. doi: 10.1093/oxfordjournals.aje.a115035. [DOI] [PubMed] [Google Scholar]
  83. Magaziner J., Tenney J. H., DeForge B., Hebel J. R., Muncie H. L., Jr, Warren J. W. Prevalence and characteristics of nursing home-acquired infections in the aged. J Am Geriatr Soc. 1991 Nov;39(11):1071–1078. doi: 10.1111/j.1532-5415.1991.tb02871.x. [DOI] [PubMed] [Google Scholar]
  84. Magnussen M. H., Robb S. S. Nosocomial infections in a long-term care facility. Am J Infect Control. 1980 Feb;8(1):12–17. doi: 10.1016/s0196-6553(80)80073-3. [DOI] [PubMed] [Google Scholar]
  85. Marrie T. J., Durant H., Kwan C. Nursing home-acquired pneumonia. A case-control study. J Am Geriatr Soc. 1986 Oct;34(10):697–702. doi: 10.1111/j.1532-5415.1986.tb04300.x. [DOI] [PubMed] [Google Scholar]
  86. Marrie T. J., Lee S. H., Faulkner R. S., Ethier J., Young C. H. Rotavirus infection in a geriatric population. Arch Intern Med. 1982 Feb;142(2):313–316. [PubMed] [Google Scholar]
  87. McElhaney J. E., Beattie B. L., Devine R., Grynoch R., Toth E. L., Bleackley R. C. Age-related decline in interleukin 2 production in response to influenza vaccine. J Am Geriatr Soc. 1990 Jun;38(6):652–658. doi: 10.1111/j.1532-5415.1990.tb01424.x. [DOI] [PubMed] [Google Scholar]
  88. McEvoy A., Dutton J., James O. F. Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly. Br Med J (Clin Res Ed) 1983 Sep 17;287(6395):789–793. doi: 10.1136/bmj.287.6395.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  89. McGeer A., Campbell B., Emori T. G., Hierholzer W. J., Jackson M. M., Nicolle L. E., Peppler C., Rivera A., Schollenberger D. G., Simor A. E. Definitions of infection for surveillance in long-term care facilities. Am J Infect Control. 1991 Feb;19(1):1–7. doi: 10.1016/0196-6553(91)90154-5. [DOI] [PubMed] [Google Scholar]
  90. Meyers B. R., Sherman E., Mendelson M. H., Velasquez G., Srulevitch-Chin E., Hubbard M., Hirschman S. Z. Bloodstream infections in the elderly. Am J Med. 1989 Apr;86(4):379–384. doi: 10.1016/0002-9343(89)90333-1. [DOI] [PubMed] [Google Scholar]
  91. Michocki R. J., Lamy P. P. The problem of pressure sores in a nursing home population: statistical data. J Am Geriatr Soc. 1976 Jul;24(7):323–328. doi: 10.1111/j.1532-5415.1976.tb06804.x. [DOI] [PubMed] [Google Scholar]
  92. Morgan D. B., Newton H. M., Schorah C. J., Jewitt M. A., Hancock M. R., Hullin R. P. Abnormal indices of nutrition in the elderly: a study of different clinical groups. Age Ageing. 1986 Mar;15(2):65–76. doi: 10.1093/ageing/15.2.65. [DOI] [PubMed] [Google Scholar]
  93. Muder R. R., Brennen C., Goetz A. M., Wagener M. M., Rihs J. D. Association with prior fluoroquinolone therapy of widespread ciprofloxacin resistance among gram-negative isolates in a Veterans Affairs medical center. Antimicrob Agents Chemother. 1991 Feb;35(2):256–258. doi: 10.1128/aac.35.2.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  94. Muder R. R., Brennen C., Wagener M. M., Goetz A. M. Bacteremia in a long-term-care facility: a five-year prospective study of 163 consecutive episodes. Clin Infect Dis. 1992 Mar;14(3):647–654. doi: 10.1093/clinids/14.3.647. [DOI] [PubMed] [Google Scholar]
  95. Muder R. R., Brennen C., Wagener M. M., Vickers R. M., Rihs J. D., Hancock G. A., Yee Y. C., Miller J. M., Yu V. L. Methicillin-resistant staphylococcal colonization and infection in a long-term care facility. Ann Intern Med. 1991 Jan 15;114(2):107–112. doi: 10.7326/0003-4819-114-2-1-107. [DOI] [PubMed] [Google Scholar]
  96. Mulligan M. E., Murray-Leisure K. A., Ribner B. S., Standiford H. C., John J. F., Korvick J. A., Kauffman C. A., Yu V. L. Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med. 1993 Mar;94(3):313–328. doi: 10.1016/0002-9343(93)90063-u. [DOI] [PubMed] [Google Scholar]
  97. Murphy S., Denman S., Bennett R. G., Greenough W. B., 3rd, Lindsay J., Zelesnick L. B. Methicillin-resistant Staphylococcus aureus colonization in a long-term-care facility. J Am Geriatr Soc. 1992 Mar;40(3):213–217. doi: 10.1111/j.1532-5415.1992.tb02070.x. [DOI] [PubMed] [Google Scholar]
  98. Murphy S., West K. P., Jr, Greenough W. B., 3rd, Cherot E., Katz J., Clement L. Impact of vitamin A supplementation on the incidence of infection in elderly nursing-home residents: a randomized controlled trial. Age Ageing. 1992 Nov;21(6):435–439. doi: 10.1093/ageing/21.6.435. [DOI] [PubMed] [Google Scholar]
  99. Mylotte J. M., Karuza J., Bentley D. W. Methicillin-resistant Staphylococcus aureus: a questionnaire survey of 75 long-term care facilities in western New York. Infect Control Hosp Epidemiol. 1992 Dec;13(12):711–718. doi: 10.1086/648344. [DOI] [PubMed] [Google Scholar]
  100. Narain J. P., Lofgren J. P., Warren E., Stead W. W. Epidemic tuberculosis in a nursing home: a retrospective cohort study. J Am Geriatr Soc. 1985 Apr;33(4):258–263. doi: 10.1111/j.1532-5415.1985.tb07113.x. [DOI] [PubMed] [Google Scholar]
  101. Nicolle L. E., Bjornson J., Harding G. K., MacDonell J. A. Bacteriuria in elderly institutionalized men. N Engl J Med. 1983 Dec 8;309(23):1420–1425. doi: 10.1056/NEJM198312083092304. [DOI] [PubMed] [Google Scholar]
  102. Nicolle L. E., Garibaldi R. A. Infection control in long-term-care facilities. Infect Control Hosp Epidemiol. 1995 Jun;16(6):348–353. doi: 10.1086/647124. [DOI] [PubMed] [Google Scholar]
  103. Nicolle L. E., Henderson E., Bjornson J., McIntyre M., Harding G. K., MacDonell J. A. The association of bacteriuria with resident characteristics and survival in elderly institutionalized men. Ann Intern Med. 1987 May;106(5):682–686. doi: 10.7326/0003-4819-106-5-682. [DOI] [PubMed] [Google Scholar]
  104. Nicolle L. E., Mayhew J. W., Bryan L. Outcome following antimicrobial therapy for asymptomatic bacteriuria in elderly women resident in an institution. Age Ageing. 1988 May;17(3):187–192. doi: 10.1093/ageing/17.3.187. [DOI] [PubMed] [Google Scholar]
  105. Nicolle L. E., Mayhew W. J., Bryan L. Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. Am J Med. 1987 Jul;83(1):27–33. doi: 10.1016/0002-9343(87)90493-1. [DOI] [PubMed] [Google Scholar]
  106. Nicolle L. E., McIntyre M., Zacharias H., MacDonell J. A. Twelve-month surveillance of infections in institutionalized elderly men. J Am Geriatr Soc. 1984 Jul;32(7):513–519. doi: 10.1111/j.1532-5415.1984.tb02236.x. [DOI] [PubMed] [Google Scholar]
  107. Nicolle L. E., McLeod J., McIntyre M., MacDonell J. A. Significance of pharyngeal colonization with aerobic gram-negative bacilli in elderly institutionalized men. Age Ageing. 1986 Jan;15(1):47–52. doi: 10.1093/ageing/15.1.47. [DOI] [PubMed] [Google Scholar]
  108. Nicolle L. E., Orr P., Duckworth H., Brunka J., Kennedy J., Urias B., Murray D., Harding G. K. Prospective study of decubitus ulcers in two long term care facilities. Can J Infect Control. 1994 Summer;9(2):35–38. [PubMed] [Google Scholar]
  109. Nicolle L. E. Urinary tract infections in long-term care facilities. Infect Control Hosp Epidemiol. 1993 Apr;14(4):220–225. doi: 10.1086/646719. [DOI] [PubMed] [Google Scholar]
  110. Norman D. C., Toledo S. D. Infections in elderly persons. An altered clinical presentation. Clin Geriatr Med. 1992 Nov;8(4):713–719. [PubMed] [Google Scholar]
  111. O'Toole R. D., Drew W. L., Dahlgren B. J., Beaty H. N. An outbreak of methicillin-resistant Staphylococcus aureus infection. Observations in hospital and nursing home. JAMA. 1970 Jul 13;213(2):257–263. [PubMed] [Google Scholar]
  112. Ouslander J. G., Greengold B., Chen S. Complications of chronic indwelling urinary catheters among male nursing home patients: a prospective study. J Urol. 1987 Nov;138(5):1191–1195. doi: 10.1016/s0022-5347(17)43546-4. [DOI] [PubMed] [Google Scholar]
  113. Ouslander J. G., Greengold B., Chen S. External catheter use and urinary tract infections among incontinent male nursing home patients. J Am Geriatr Soc. 1987 Dec;35(12):1063–1070. doi: 10.1111/j.1532-5415.1987.tb04922.x. [DOI] [PubMed] [Google Scholar]
  114. Ouslander J. G. Medical care in the nursing home. JAMA. 1989 Nov 10;262(18):2582–2590. [PubMed] [Google Scholar]
  115. Patriarca P. A., Arden N. H., Koplan J. P., Goodman R. A. Prevention and control of type A influenza infections in nursing homes. Benefits and costs of four approaches using vaccination and amantadine. Ann Intern Med. 1987 Nov;107(5):732–740. doi: 10.7326/0003-4819-107-5-732. [DOI] [PubMed] [Google Scholar]
  116. Patriarca P. A., Weber J. A., Parker R. A., Orenstein W. A., Hall W. N., Kendal A. P., Schonberger L. B. Risk factors for outbreaks of influenza in nursing homes. A case-control study. Am J Epidemiol. 1986 Jul;124(1):114–119. doi: 10.1093/oxfordjournals.aje.a114355. [DOI] [PubMed] [Google Scholar]
  117. Peck A., Cohen C. E., Mulvihill M. N. Long-term enteral feeding of aged demented nursing home patients. J Am Geriatr Soc. 1990 Nov;38(11):1195–1198. doi: 10.1111/j.1532-5415.1990.tb01498.x. [DOI] [PubMed] [Google Scholar]
  118. Pegues D. A., Woernle C. H. An outbreak of acute nonbacterial gastroenteritis in a nursing home. Infect Control Hosp Epidemiol. 1993 Feb;14(2):87–94. doi: 10.1086/646688. [DOI] [PubMed] [Google Scholar]
  119. Perez-Stable E. J., Flaherty D., Schecter G., Slutkin G., Hopewell P. C. Conversion and reversion of tuberculin reactions in nursing home residents. Am Rev Respir Dis. 1988 Apr;137(4):801–804. doi: 10.1164/ajrccm/137.4.801. [DOI] [PubMed] [Google Scholar]
  120. Peterson P. K., Stein D., Guay D. R., Logan G., Obaid S., Gruninger R., Davies S., Breitenbucher R. Prospective study of lower respiratory tract infections in an extended-care nursing home program: potential role of oral ciprofloxacin. Am J Med. 1988 Aug;85(2):164–171. doi: 10.1016/s0002-9343(88)80336-x. [DOI] [PubMed] [Google Scholar]
  121. Phair J., Kauffman C. A., Bjornson A., Adams L., Linnemann C., Jr Failure to respond to influenza vaccine in the aged: correlation with B-cell number and function. J Lab Clin Med. 1978 Nov;92(5):822–828. [PubMed] [Google Scholar]
  122. Phillips S. L., Branaman-Phillips J. The use of intramuscular cefoperazone versus intramuscular ceftriaxone in patients with nursing home-acquired pneumonia. J Am Geriatr Soc. 1993 Oct;41(10):1071–1074. doi: 10.1111/j.1532-5415.1993.tb06454.x. [DOI] [PubMed] [Google Scholar]
  123. Pickering T. D., Gurwitz J. H., Zaleznik D., Noonan J. P., Avorn J. The appropriateness of oral fluoroquinolone-prescribing in the long-term care setting. J Am Geriatr Soc. 1994 Jan;42(1):28–32. doi: 10.1111/j.1532-5415.1994.tb06069.x. [DOI] [PubMed] [Google Scholar]
  124. Price L. E., Sarubbi F. A., Jr, Rutala W. A. Infection control programs in twelve North Carolina extended care facilities. Infect Control. 1985 Nov;6(11):437–441. doi: 10.1017/s0195941700064778. [DOI] [PubMed] [Google Scholar]
  125. Reid R. I., Briggs R. S., Seal D. V., Pearson A. D. Virulent Streptococcus pyogenes: outbreak and spread within a geriatric unit. J Infect. 1983 May;6(3):219–225. doi: 10.1016/s0163-4453(83)93549-1. [DOI] [PubMed] [Google Scholar]
  126. Rice L. B., Willey S. H., Papanicolaou G. A., Medeiros A. A., Eliopoulos G. M., Moellering R. C., Jr, Jacoby G. A. Outbreak of ceftazidime resistance caused by extended-spectrum beta-lactamases at a Massachusetts chronic-care facility. Antimicrob Agents Chemother. 1990 Nov;34(11):2193–2199. doi: 10.1128/aac.34.11.2193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  127. Ruben F. L., Norden C. W., Heisler B., Korica Y. An outbreak of Streptococcus pyogenes infections in a nursing home. Ann Intern Med. 1984 Oct;101(4):494–496. doi: 10.7326/0003-4819-101-4-494. [DOI] [PubMed] [Google Scholar]
  128. Rudman D., Hontanosas A., Cohen Z., Mattson D. E. Clinical correlates of bacteremia in a Veterans Administration extended care facility. J Am Geriatr Soc. 1988 Aug;36(8):726–732. doi: 10.1111/j.1532-5415.1988.tb07175.x. [DOI] [PubMed] [Google Scholar]
  129. Ryan C. A., Tauxe R. V., Hosek G. W., Wells J. G., Stoesz P. A., McFadden H. W., Jr, Smith P. W., Wright G. F., Blake P. A. Escherichia coli O157:H7 diarrhea in a nursing home: clinical, epidemiological, and pathological findings. J Infect Dis. 1986 Oct;154(4):631–638. doi: 10.1093/infdis/154.4.631. [DOI] [PubMed] [Google Scholar]
  130. Saltzman R. L., Peterson P. K. Immunodeficiency of the elderly. Rev Infect Dis. 1987 Nov-Dec;9(6):1127–1139. doi: 10.1093/clinids/9.6.1127. [DOI] [PubMed] [Google Scholar]
  131. Sapico F. L., Ginunas V. J., Thornhill-Joynes M., Canawati H. N., Capen D. A., Klein N. E., Khawam S., Montgomerie J. Z. Quantitative microbiology of pressure sores in different stages of healing. Diagn Microbiol Infect Dis. 1986 May;5(1):31–38. doi: 10.1016/0732-8893(86)90089-1. [DOI] [PubMed] [Google Scholar]
  132. Scheckler W. E., Peterson P. J. Infections and infection control among residents of eight rural Wisconsin nursing homes. Arch Intern Med. 1986 Oct;146(10):1981–1984. [PubMed] [Google Scholar]
  133. Schicker J. M., Franson T. R., Duthie E. H., Jr, LeClair S. M. Comparison of methods for calculation and depiction of incidence infection rates in long-term care facilities. J Clin Epidemiol. 1988;41(8):757–761. doi: 10.1016/0895-4356(88)90162-x. [DOI] [PubMed] [Google Scholar]
  134. Schwartz B., Ussery X. T. Group A streptococcal outbreaks in nursing homes. Infect Control Hosp Epidemiol. 1992 Dec;13(12):742–747. doi: 10.1086/648348. [DOI] [PubMed] [Google Scholar]
  135. Setia U., Serventi I., Lorenz P. Bacteremia in a long-term care facility. Spectrum and mortality. Arch Intern Med. 1984 Aug;144(8):1633–1635. [PubMed] [Google Scholar]
  136. Setia U., Serventi I., Lorenz P. Nosocomial infections among patients in a long-term care facility: spectrum, prevalence, and risk factors. Am J Infect Control. 1985 Apr;13(2):57–62. doi: 10.1016/0196-6553(85)90083-5. [DOI] [PubMed] [Google Scholar]
  137. Shapiro E. D., Clemens J. D. A controlled evaluation of the protective efficacy of pneumococcal vaccine for patients at high risk of serious pneumococcal infections. Ann Intern Med. 1984 Sep;101(3):325–330. doi: 10.7326/0003-4819-101-3-325. [DOI] [PubMed] [Google Scholar]
  138. Shepard M. A., Parker D., DeClercque N. The under-reporting of pressure sores in patients transferred between hospital and nursing home. J Am Geriatr Soc. 1987 Feb;35(2):159–160. doi: 10.1111/j.1532-5415.1987.tb01346.x. [DOI] [PubMed] [Google Scholar]
  139. Sherman F. T., Tucci V., Libow L. S., Isenberg H. D. Nosocomial urinary-tract infections in a skilled nursing facility. J Am Geriatr Soc. 1980 Oct;28(10):456–461. doi: 10.1111/j.1532-5415.1980.tb01119.x. [DOI] [PubMed] [Google Scholar]
  140. Shlaes D. M., Currie-McCumber C. A., Lehman M. H. Introduction of a plasmid encoding the OHIO-1 beta-lactamase to an intermediate care ward by patient transfer. Infect Control Hosp Epidemiol. 1988 Jul;9(7):317–319. doi: 10.1086/645861. [DOI] [PubMed] [Google Scholar]
  141. Shlaes D. M., Lehman M. H., Currie-McCumber C. A., Kim C. H., Floyd R. Prevalence of colonization with antibiotic resistant gram-negative bacilli in a nursing home care unit: the importance of cross-colonization as documented by plasmid analysis. Infect Control. 1986 Nov;7(11):538–545. doi: 10.1017/s0195941700065280. [DOI] [PubMed] [Google Scholar]
  142. Smith P. F., Stricof R. L., Shayegani M., Morse D. L. Cluster of Haemophilus influenzae type b infections in adults. JAMA. 1988 Sep 9;260(10):1446–1449. [PubMed] [Google Scholar]
  143. Smith P. W. Consensus conference on nosocomial infections in long-term care facilities. Am J Infect Control. 1987 Jun;15(3):97–100. doi: 10.1016/0196-6553(87)90162-3. [DOI] [PubMed] [Google Scholar]
  144. Standfast S. J., Michelsen P. B., Baltch A. L., Smith R. P., Latham E. K., Spellacy A. B., Venezia R. A., Andritz M. H. A prevalence survey of infections in a combined acute and long-term care hospital. Infect Control. 1984 Apr;5(4):177–184. doi: 10.1017/s019594170005918x. [DOI] [PubMed] [Google Scholar]
  145. Staynor K., Foster G., McArthur M., McGeer A., Petric M., Simor A. E. Influenza A outbreak in a nursing home: the value of early diagnosis and the use of amantadine hydrochloride. Can J Infect Control. 1994 Winter;9(4):109–111. [PubMed] [Google Scholar]
  146. Stead W. W., Lofgren J. P., Warren E., Thomas C. Tuberculosis as an endemic and nosocomial infection among the elderly in nursing homes. N Engl J Med. 1985 Jun 6;312(23):1483–1487. doi: 10.1056/NEJM198506063122304. [DOI] [PubMed] [Google Scholar]
  147. Stead W. W. Tuberculosis among elderly persons: an outbreak in a nursing home. Ann Intern Med. 1981 May;94(5):606–610. doi: 10.7326/0003-4819-94-5-606. [DOI] [PubMed] [Google Scholar]
  148. Steinmiller A. M., Robb S. S., Muder R. R. Prevalence of nosocomial infection in long-term-care Veterans Administration medical centers. Am J Infect Control. 1991 Jun;19(3):143–146. doi: 10.1016/0196-6553(91)90020-d. [DOI] [PubMed] [Google Scholar]
  149. Storch G. A., Radcliff J. L., Meyer P. L., Hinrichs J. H. Methicillin-resistant Staphylococcus aureus in a nursing home. Infect Control. 1987 Jan;8(1):24–29. doi: 10.1017/s0195941700066947. [DOI] [PubMed] [Google Scholar]
  150. Stover B. H., Duff A., Adams G., Buck G., Hancock G., Rabalais G. Emergence and control of methicillin-resistant Staphylococcus aureus in a children's hospital and pediatric long-term care facility. Am J Infect Control. 1992 Oct;20(5):248–255. doi: 10.1016/s0196-6553(05)80198-1. [DOI] [PubMed] [Google Scholar]
  151. Strausbaugh L. J., Jacobson C., Sewell D. L., Potter S., Ward T. T. Antimicrobial therapy for methicillin-resistant Staphylococcus aureus colonization in residents and staff of a Veterans Affairs nursing home care unit. Infect Control Hosp Epidemiol. 1992 Mar;13(3):151–159. doi: 10.1086/646499. [DOI] [PubMed] [Google Scholar]
  152. Strausbaugh L. J., Jacobson C., Sewell D. L., Potter S., Ward T. T. Methicillin-resistant Staphylococcus aureus in extended-care facilities: experiences in a Veterans' Affairs nursing home and a review of the literature. Infect Control Hosp Epidemiol. 1991 Jan;12(1):36–45. doi: 10.1086/646236. [DOI] [PubMed] [Google Scholar]
  153. Sturm A. W., Mostert R., Rouing P. J., van Klingeren B., van Alphen L. Outbreak of multiresistant non-encapsulated Haemophilus influenzae infections in a pulmonary rehabilitation centre. Lancet. 1990 Jan 27;335(8683):214–216. doi: 10.1016/0140-6736(90)90291-c. [DOI] [PubMed] [Google Scholar]
  154. Terpenning M. S., Bradley S. F., Wan J. Y., Chenoweth C. E., Jorgensen K. A., Kauffman C. A. Colonization and infection with antibiotic-resistant bacteria in a long-term care facility. J Am Geriatr Soc. 1994 Oct;42(10):1062–1069. doi: 10.1111/j.1532-5415.1994.tb06210.x. [DOI] [PubMed] [Google Scholar]
  155. Thomas D. R., Bennett R. G., Laughon B. E., Greenough W. B., 3rd, Bartlett J. G. Postantibiotic colonization with Clostridium difficile in nursing home patients. J Am Geriatr Soc. 1990 Apr;38(4):415–420. doi: 10.1111/j.1532-5415.1990.tb03539.x. [DOI] [PubMed] [Google Scholar]
  156. Thomas J. C., Bridge J., Waterman S., Vogt J., Kilman L., Hancock G. Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing facility. Infect Control Hosp Epidemiol. 1989 Mar;10(3):106–110. doi: 10.1086/645976. [DOI] [PubMed] [Google Scholar]
  157. Thompson J. S., Robbins J., Cooper J. K. Nutrition and immune function in the geriatric population. Clin Geriatr Med. 1987 May;3(2):309–317. [PubMed] [Google Scholar]
  158. Thurn J. R., Belongia E. A., Crossley K. Methicillin-resistant Staphylococcus aureus in Minnesota nursing homes. J Am Geriatr Soc. 1991 Nov;39(11):1105–1109. doi: 10.1111/j.1532-5415.1991.tb02877.x. [DOI] [PubMed] [Google Scholar]
  159. Valenti W. M., Trudell R. G., Bentley D. W. Factors predisposing to oropharyngeal colonization with gram-negative bacilli in the aged. N Engl J Med. 1978 May 18;298(20):1108–1111. doi: 10.1056/NEJM197805182982002. [DOI] [PubMed] [Google Scholar]
  160. Vigild M. Oral mucosal lesions among institutionalized elderly in Denmark. Community Dent Oral Epidemiol. 1987 Dec;15(6):309–313. doi: 10.1111/j.1600-0528.1987.tb01741.x. [DOI] [PubMed] [Google Scholar]
  161. Vlahov D., Tenney J. H., Cervino K. W., Shamer D. K. Routine surveillance for infections in nursing homes: experience at two facilities. Am J Infect Control. 1987 Apr;15(2):47–53. doi: 10.1016/0196-6553(87)90001-0. [DOI] [PubMed] [Google Scholar]
  162. Warren J. W., Damron D., Tenney J. H., Hoopes J. M., Deforge B., Muncie H. L., Jr Fever, bacteremia, and death as complications of bacteriuria in women with long-term urethral catheters. J Infect Dis. 1987 Jun;155(6):1151–1158. doi: 10.1093/infdis/155.6.1151. [DOI] [PubMed] [Google Scholar]
  163. Warren J. W., Muncie H. L., Jr, Hall-Craggs M. Acute pyelonephritis associated with bacteriuria during long-term catheterization: a prospective clinicopathological study. J Infect Dis. 1988 Dec;158(6):1341–1346. doi: 10.1093/infdis/158.6.1341. [DOI] [PubMed] [Google Scholar]
  164. Warren J. W., Palumbo F. B., Fitterman L., Speedie S. M. Incidence and characteristics of antibiotic use in aged nursing home patients. J Am Geriatr Soc. 1991 Oct;39(10):963–972. doi: 10.1111/j.1532-5415.1991.tb04042.x. [DOI] [PubMed] [Google Scholar]
  165. Warren J. W. Providencia stuartii: a common cause of antibiotic-resistant bacteriuria in patients with long-term indwelling catheters. Rev Infect Dis. 1986 Jan-Feb;8(1):61–67. doi: 10.1093/clinids/8.1.61. [DOI] [PubMed] [Google Scholar]
  166. Warren J. W., Steinberg L., Hebel J. R., Tenney J. H. The prevalence of urethral catheterization in Maryland nursing homes. Arch Intern Med. 1989 Jul;149(7):1535–1537. [PubMed] [Google Scholar]
  167. Warren J. W., Tenney J. H., Hoopes J. M., Muncie H. L., Anthony W. C. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis. 1982 Dec;146(6):719–723. doi: 10.1093/infdis/146.6.719. [DOI] [PubMed] [Google Scholar]
  168. Wasserman M., Levinstein M., Keller E., Lee S., Yoshikawa T. T. Utility of fever, white blood cells, and differential count in predicting bacterial infections in the elderly. J Am Geriatr Soc. 1989 Jun;37(6):537–543. doi: 10.1111/j.1532-5415.1989.tb05686.x. [DOI] [PubMed] [Google Scholar]
  169. Wayne S. J., Rhyne R. L., Stratton M. Longitudinal prescribing patterns in a nursing home population. J Am Geriatr Soc. 1992 Jan;40(1):53–56. doi: 10.1111/j.1532-5415.1992.tb01829.x. [DOI] [PubMed] [Google Scholar]
  170. Welty C., Burstin S., Muspratt S., Tager I. B. Epidemiology of tuberculous infection in a chronic care population. Am Rev Respir Dis. 1985 Jul;132(1):133–136. doi: 10.1164/arrd.1985.132.1.133. [DOI] [PubMed] [Google Scholar]
  171. White K. E., Hedberg C. W., Edmonson L. M., Jones D. B., Osterholm M. T., MacDonald K. L. An outbreak of giardiasis in a nursing home with evidence for multiple modes of transmission. J Infect Dis. 1989 Aug;160(2):298–304. doi: 10.1093/infdis/160.2.298. [DOI] [PubMed] [Google Scholar]
  172. Wilkieson C., Samaranayake L. P., MacFarlane T. W., Lamey P. J., MacKenzie D. Oral candidosis in the elderly in long term hospital care. J Oral Pathol Med. 1991 Jan;20(1):13–16. doi: 10.1111/j.1600-0714.1991.tb00880.x. [DOI] [PubMed] [Google Scholar]
  173. Wingard E., Shlaes J. H., Mortimer E. A., Shlaes D. M. Colonization and cross-colonization of nursing home patients with trimethoprim-resistant gram-negative bacilli. Clin Infect Dis. 1993 Jan;16(1):75–81. doi: 10.1093/clinids/16.1.75. [DOI] [PubMed] [Google Scholar]
  174. Zervos M. J., Terpenning M. S., Schaberg D. R., Therasse P. M., Medendorp S. V., Kauffman C. A. High-level aminoglycoside-resistant enterococci. Colonization of nursing home and acute care hospital patients. Arch Intern Med. 1987 Sep;147(9):1591–1594. doi: 10.1001/archinte.147.9.1591. [DOI] [PubMed] [Google Scholar]
  175. Zimmer J. G., Bentley D. W., Valenti W. M., Watson N. M. Systemic antibiotic use in nursing homes. A quality assessment. J Am Geriatr Soc. 1986 Oct;34(10):703–710. doi: 10.1111/j.1532-5415.1986.tb04301.x. [DOI] [PubMed] [Google Scholar]

Articles from Clinical Microbiology Reviews are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES