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Nursing home-acquired bloodstream infection
1Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, New York, USA. mylotte@buffalo.edu
Infection Control and Hospital Epidemiology
|November 10, 2005
Summary
Epidemiology of nursing home-acquired bloodstream infections (BSI) has remained stable over 20 years, with urinary tract infections being the most common source. Routine blood cultures are not recommended due to low incidence and yield.
Area of Science:
- Infectious Diseases
- Epidemiology
- Healthcare-Associated Infections
Background:
- Nursing home-acquired bloodstream infections (BSI) represent a significant concern in geriatric care.
- Understanding the epidemiological trends and causative agents of BSIs is crucial for effective infection control.
Purpose of the Study:
- To review North American studies on nursing home-acquired BSI over the past 20 years.
- To identify changes in BSI epidemiology and define appropriate indications for blood cultures in nursing homes.
Main Methods:
- A comprehensive Medline search was conducted for studies published between 1980 and August 2003.
- Seven relevant studies on nursing home-acquired BSI were identified and analyzed.
Main Results:
- The incidence of nursing home-acquired BSI is low (0.3 per 1,000 resident care-days).
- Urinary tract infections consistently account for approximately 50% of BSIs, with little change in bacteriology over two decades.
- Gram-negative bacilli, particularly Escherichia coli, remain the most common pathogens; Methicillin-resistant Staphylococcus aureus (MRSA) is the most frequent resistant organism.
Conclusions:
- There has been minimal change in the epidemiology of nursing home-acquired BSI over the past 20 years.
- The low incidence and low yield (< or = 6%) of positive blood cultures do not support routine use in nursing home settings.
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