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Acute gastroenteritis in three community-based nursing homes

R V Sims1, R J Hauser, A O Adewale

  • 1Geriatrics Division, Philadelphia VA Medical Center, Pennsylvania, USA.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|September 1, 1995
PubMed
Summary

Acute gastroenteritis is common in nursing homes, affecting elderly residents. Clostridium difficile was identified as a significant cause of diarrhea, with Foley catheter use increasing risk.

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Area of Science:

  • Gerontology
  • Infectious Diseases
  • Epidemiology

Background:

  • Acute gastroenteritis poses significant health risks, including morbidity and mortality, particularly in elderly populations residing in long-term care facilities.
  • A prospective study was conducted to assess the incidence and risk factors of acute diarrhea in community-based nursing homes.

Purpose of the Study:

  • To evaluate the incidence of acute gastroenteritis in nursing home residents.
  • To identify specific risk factors associated with acute diarrhea in this population.
  • To investigate the role of Clostridium difficile in nursing home-acquired gastroenteritis.

Main Methods:

  • A cohort study involving 572 residents across three nursing homes over an 8-month period.
  • Diarrhea cases were defined by acute onset of loose stools and specific clinical indicators or outbreak association.

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  • Stool cultures for Clostridium difficile were performed on patients in one nursing home (NH 1).

    • Main Results:

    • Fifty-three cases of gastroenteritis were identified, with varying incidence rates across the three facilities (14.6 to 36.4 cases/100 patient-years).
    • Use of a Foley catheter was associated with an increased risk of diarrhea (OR = 2.57).
    • Six cases of Clostridium difficile enteritis and one case of Aeromonas/Pleisomonas species infection were diagnosed; one C. difficile case was hospital-acquired.

    Conclusions:

    • Acute gastroenteritis is a prevalent issue in nursing homes, with identifiable risk factors.
    • Clostridium difficile appears to play a significant role in the etiology of diarrhea within these settings.
    • Targeted interventions may be necessary to mitigate gastroenteritis outbreaks and manage risk factors like catheter use.