Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016‒2019

Abstract

Keywords:Long-term care acute respiratory infection rapid influenza diagnostic testing influenza a b s t r a c t Residents of long-term care facilities (LCTFs) have high morbidity and mortality associated with acute respiratory infections (ARIs). Limited information exists on the virology of ARI in LTCFs, where virological testing is reactive. We report on findings of a surveillance feasibility substudy from a larger prospective trial of introducing rapid influenza diagnostic testing (RIDT) at 10 Wisconsin LTCFs. Any resident with symptoms consistent with ARI had a nasal swab specimen collected for RIDT by staff. Following RIDT, the residual swab was placed into viral transport medium and tested for influenza using Reverse transcription polymerase chain reaction, and for 20 pathogens using a multiplex polymerase chain reaction respiratory pathogen panel. Numbers of viruses in each of 7 categories (influenza A, influenza B, coronaviruses, human metapneumovirus, parainfluenza, respiratory syncytial virus, and rhinovirus/enterovirus) across the 3 years were compared using c 2 . Totals of 160, 215, and 122 specimens were collected

Relationships Between Community Virus Activity and Cardiorespiratory Rehospitalizations From Post-Acute Care

“… 22 – 28 For such measures to be successful, SNFs must overcome challenges such as maintaining adequate supplies and personnel resources, ensuring that test result turnaround and resident cohorting are efficient, and balancing the intensity of infection control practices with cost-effectiveness. 29 In the case of respiratory virus testing, multivirus respiratory pathogen panels may be an efficient method to guide diagnosis and treatment 30 and may provide useful information on the burden of other respiratory viruses (eg, human metapneumovirus, parainfluenza, rhinovirus) in SNFs, for which literature is scarce. 31 However, future research should first compare various testing strategies specifically in the SNF setting to examine cost-effectiveness, sustainability, and clinical outcomes.…”

Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain

“…Respiratory infections are a very frequent cause of morbidity and mortality in nursing homes whose etiological diagnosis has improved with the inclusion of new diagnostic technologies [74][75][76]. As for viral etiology, influenza, Respiratory Syncytial Virus (RSV) infection, Coronavirus and Metapneumovirus infections stand out [49,[77][78][79][80][81].…”

Progress and Challenges in the Management of Nursing Home Infections

“…This issue of JAMDA includes 5 articles on respiratory disease in long-term care residents. They include policy recommendations from AMDA's Infection Advisory Subcommittee on mandatory influenza vaccination for nursing home staff 6 ; data verifying the wide variety of viral illnesses that occur in nursing home residents and for which antibiotics are not helpful 7 ; description of an especially severe outbreak of metapneumovirus in a French nursing home 8 ; a report documenting that hospital-associated influenza deaths can serve as sentinels warning nursing homes of high risk for an outbreak in their setting 9 ; and a study of rapid viral and procalcitonin assays to help nursing home physicians determine whether an incipient respiratory infection is viral or bacterial. 10 Skin and soft tissue infections comprise the third common reason antibiotics are prescribed in the nursing home.…”