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Salmonella outbreak in a nursing home.

M Choi1, T T Yoshikawa, J Bridge

  • 1Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, West Los Angeles, California.

Journal of the American Geriatrics Society
|May 1, 1990
PubMed
Summary
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A 1987 Salmonella outbreak in a nursing home caused varied gastrointestinal illness, with some residents needing hospitalization. Antibiotic treatment prolonged pathogen shedding in patients, highlighting the economic burden of such outbreaks.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Geriatric Medicine

Background:

  • Nursing home outbreaks of Salmonella gastroenteritis pose significant public health challenges.
  • Salmonella Heidelberg was identified as the causative agent in a 1987 outbreak.
  • Understanding the epidemiology and clinical impact of these outbreaks is crucial for effective control.

Purpose of the Study:

  • To retrospectively review a Salmonella gastroenteritis outbreak in a community nursing home.
  • To investigate the clinical presentation, duration of illness, and economic impact.
  • To identify factors influencing pathogen shedding and inform future outbreak management.

Main Methods:

  • Retrospective review of an outbreak of Salmonella gastroenteritis.
  • Analysis of clinical data, including diarrheal illness and hospitalization rates.

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  • Microbiological investigation to identify Salmonella serotypes and track pathogen excretion.

    • Main Results:

    • Forty-four of 199 residents developed diarrheal illness; Salmonella Heidelberg was isolated in 19 cases.
    • No common source of infection was definitively identified despite extensive investigation.
    • Symptomatic patients experienced a spectrum of illness, with 26% requiring hospitalization.
    • Antibiotic treatment prolonged Salmonella Heidelberg shedding, with a median of 14.5 weeks compared to 6 weeks in untreated residents.

    Conclusions:

    • Salmonella gastroenteritis in nursing home patients presents with a variable clinical spectrum, from mild to severe illness.
    • Salmonella outbreaks in nursing homes incur substantial economic costs due to investigation, isolation, hospitalization, and potential closure.
    • Prolonged pathogen excretion in treated patients necessitates careful consideration of treatment strategies and isolation protocols.