Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria

Abstract

(See the commentary by Moro, on pages 978–980.) Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.

Using Antibiograms to Improve Antibiotic Prescribing in Skilled Nursing Facilities

“…We estimated the frequency of inappropriate emtential associated poor health outcomes, resources are often pirical antibiotic prescribing in 3 Maryland SNFs and mealimited for diagnosis of infections and to guide empirical sured the effect of the antibiograms on antibiotic prescribing antibiotic therapy. 4,5 A recent review by Stone et al 6 updating in 1 of the SNFs. These data are essential to improve our understanding of the burden of inappropriate empirical antibiotic prescribing in SNFs and to identify opportunities to improve antibiotic prescribing in this setting.…”

Indicators of health and safety among institutionalized older adults

“…In long-term residential care institutions in Brazil and worldwide (10) , an important indicator used to assess health conditions is the incidence of acute diarrhea, which can be of lesser or greater severity. Despite the clinical signs, the etiology of diarrhea is difficult to define and its evolution depends on incubation period, eating habits, occupational risks, use of antibiotics, institutionalization, and immunological status (11) .…”

“…Recommended actions include immediate clinical and laboratory assessment in case of outbreaks; and initiating oral rehydration therapy and unrestricted diets (10) , with the exception of older adults with severe dehydration, who must receive intensified care.…”

“…Among them the most common are cellulite, pressure ulcers, scabies, mucocutaneous fungal infections, infections by the herpes virus and conjunctivitis (10) , which are the disorders most commonly seen in older adults. In this study, the incidence of scabies was as high as that of a study conducted in England in seven older adult institutions, in which the rate varied from 2% to 50%, of which 95% were older adults with dementia, 79.5% with incontinence, and 61.5% with impaired mobility (15) .…”

Antimicrobial Stewardship Initiative in Treatment of Urinary Tract Infections at a Rehabilitation and Complex Continuing Care Hospital

“…13 Because the microbiology laboratory analysis and report depended on the method of urine collection, the UTI guideline included microbiologic criteria for a positive culture result from a midstream urine sample versus a catheter specimen, as well as providing clear labelling instructions defining the method of urine collection. Specifically, when 3 or more organisms were identified in a midstream specimen, the specimen would typically be rejected by the laboratory because of possible contamination; in contrast, up to 3 dominant organisms would be characterized from a catheter specimen.…”