Current status of nosocomial infection control in extended care facilities
Article Abstract:
The definition of nosocomial infection can be extended to include infections acquired in extended care facilities (ECFs, facilities that provide long-term care), as well as those acquired in hospitals. Nosocomial infection epidemics occurring in the 1950s and 1960s provided the incentive for developing infection control programs in hospitals. In the late 1970s, an increased awareness of the hazards of nosocomial infections led to the adoption of infection control programs in ECFs. The average rate of infection in ECFs is estimated to range from 5 to 10 infections per resident per month. This translates to a national rate of 1.5 million ECF nosocomial infections per year. This is lower than the average national rate for hospitals (2 million infections per year). The most common types of infections in ECFs are urinary tract infections, lung infections, skin infections, and infectious gastroenteritis (inflammation in the stomach and intestines). The most common epidemics in ECFs are tuberculosis, influenza, salmonellosis (a type of food poisoning, usually from poultry products), viral gastroenteritis, conjunctivitis (inflammation of eye membranes), and scabies. With the exception of salmonellosis, the usual sources of these infections are the patients, staff and visitors. Most ECFs do not have resident and employee health programs. Such programs should be developed and should require preadmission screening for contagious diseases, tuberculosis skin testing, and vaccination for tetanus/diphtheria, influenza and pneumococcus. Future studies should focus on the risk factors, morbidity and mortality associated with nosocomial infections, and on monitoring the effectiveness of infection control programs in order to identify areas that require more attention. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Reactive arthritis after mycobacterium avium-intracellulare infection: Poncet's disease revisited
Article Abstract:
Reactive arthritis, a joint inflammation due to infection, has not previously been reported in conjunction with infection by mycobacterium avium-intracellulare (MAI). This joint disorder commonly occurs after infections of organ systems, such as the gastrointestinal and urogenital tracts, with various types of microorganisms. The occurrence of reactive arthritis after lung infection with mycobacteria tuberculosis was first reported in 1987. The infection of the lung by abnormal mycobacteria such as MIA is occurring more frequently in patients with acquired immunodeficiency syndrome (AIDS) and in patients without predisposing conditions. A case is described of a 69-year-old woman who developed reactive arthritis associated with infection with MAI. The patient developed pain and swelling within the temporomandibular joint of the jaw. She was later shown by X-ray and laboratory findings to have lung infection with MAI. The patient was treated with antibiotics and anti-inflammatory agents, and recovered. Elderly patients do not commonly develop reactive arthritis after gastrointestinal or urogenital infections. However, because the prevalence of MAI infection is increasing among the elderly, MAI should be considered as a possible infective agent causing reactive arthritis in this population. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Desensitization to sulfonamides in patients with HIV infection
Article Abstract:
The use of sulfonamide drugs has been associated with the development of skin reactions, which can often be managed by simply by withdrawing them. However, these drugs are preferred for treating Pneumonia carinii pneumonia and toxoplasmic encephalitis, an inflammation of the brain due to infection with the microorganism Toxoplasma; these conditions frequently develop in patients with AIDS. Some studies have shown that patients with sulfonamide-induced skin reactions can be made to become less sensitive to the drug. Desensitization to sulfonamides was assessed among 13 patients with AIDS, who had been treated with sulfonamides for infections. Nine patients underwent a desensitization procedure without skin reactions, whereas four patients developed skin reactions accompanied by fever. Among the patients with skin reactions, two cases developed during desensitization and two cases occurred while patients were receiving full doses of the sulfonamides. Two of four cases of sulfonamide-induced skin reactions were managed with the antihistamine diphenhydramine, whereas the other two patients left the trial. The results show that most AIDS patients who develop skin reactions to sulfonamides may be successfully desensitized to these drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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