American Journal of Epidemiology Vol. 135, No. 6: 685-696
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Intensive Surveillance for Infections in a Three-year Study of Nursing Home Patients
1Department of Community and Famiy Medicine, University of California at San Diego La Jolla, CA
2Departments of Medicine and Pathology, University of California at San Diego, La Jofla, CA, and the Veterans Administration Medical Center San Diego, CA
3School of Nursing, San Diego State University San Diego, CA
Reprint requests to Marguerite M. Jackson, Epidemiology Unit, University of Cafifornia at San Diego Medical Center, 225 Dickinson Street 8951, San Diego, CA 921036951.
The authors report the results of a 3-year (August 1984-May 1987) prospective study of intensive surveillance for nursing home-associated infections in 666 patients in a 300–bed nursing home in San Diego, California. Ninety-three percent (666 of 714) of the eligible subjects enrolled; 75% were women. The mean age of the subjects was 81.6 years. Lengths of stay ranged from 1 day to 1,025 days, with a mean of 166 days; the cumulative length of stay for all subjects was 110,746 days (303 years). Operational definitions that were heavily dependent on evaluation of clinical signs and symptoms were used by nurse practitioners in weekly or biweekly assessments of all patients to identify infections. The overall incidence of nursing home-associated infection was 7.1 infections/1,000 patient-days. Many of the infections would not have been recognized by persons less skilled than nurse practitioners. Among the 788 nursing home-associated infections identified, 362 (47%) were in the respiratory tract (286 lower respiratory and 76 upper respiratory); 200 (25%) were associated with skin and subcutaneous and mucous membranes; 140 (18%) were symptomatic urinary tract infections; 13 (2%) were bacteremia; and 73 (9%) were other infections. Am J Epidemiol 1992;135:685–96.
aged; cross infection; diagnosis; disease outbreaks; nursing homes
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