| Preface to the Second Edition | p. v |
| Preface to the First Edition | p. vii |
| Acknowledgment | p. xi |
| Contributors | p. xxv |
| Principles of Aging, Long-Term Care, and Infection | |
| Demographics and Economics of Long-Term Care | p. 1 |
| Key Points | p. 1 |
| Introduction | p. 2 |
| Demand for Nursing Facility Care | p. 2 |
| Economics of LTC | p. 8 |
| Evolving Changes in LTC | p. 11 |
| References | p. 12 |
| Epidemiology and Special Aspects of Infections Diseases in Aging | p. 15 |
| Key Points | p. 15 |
| Conceptual Basis for Importance of Infection and Aging | p. 15 |
| Special Aspects of Infections in the Elderly | p. 17 |
| Suggested Reading | p. 19 |
| References | p. 19 |
| Evaluation of Infections in Long-Term Care Facilities Verses Acute Care Hospitals | p. 21 |
| Key Points | p. 21 |
| Introduction | p. 21 |
| When to Transfer Long-Term Care Facilities Residents to an Acute Care Setting | p. 25 |
| Summary | p. 27 |
| Suggested Reading | p. 27 |
| References | p. 28 |
| Role of Functional Assessment in Evaluating and Managing Infections in Long-Term Care | p. 31 |
| Key Points | p. 31 |
| Introduction | p. 32 |
| Importance of Functional Assessment During Transitions of Care | p. 37 |
| Functional Assessment in LTC | p. 42 |
| Process of Functional Assessment | p. 43 |
| Infection Control and Function | p. 46 |
| Summary | p. 46 |
| Suggested Reading | p. 47 |
| References | p. 47 |
| Impaired Immunity and Increased Risk of Infections in Older Adults: Impact of Chronic Disease on Immunosenescence | p. 49 |
| Key Points | p. 49 |
| Introduction | p. 50 |
| Immunosenescence | p. 50 |
| Impaired Immunity Due to the Impact of Chronic Illness on an Aging Immune System (Immunosenescence) | p. 57 |
| Inflammatory Mediators and Immunity | p. 59 |
| Impact of Age and Chronic Illness-Related Impaired Immunity on Infections | p. 62 |
| Concluding Remarks | p. 66 |
| Suggested Reading | p. 67 |
| References | p. 68 |
| Nutrition and Infection | p. 71 |
| Key Points | p. 71 |
| Introduction | p. 72 |
| Prevalence and Causes of Malnutrition in Older Residents of LTCFs | p. 72 |
| Assessment of Nutritional Status and Consequences of Malnutrition in Long-Term Care Residents | p. 75 |
| Nutritional Interventions to Reduce Infection and Improve Outcomes in LTCF Residents | p. 77 |
| Specific Syndromes Where Nutritional Supplementation May Be of Benefit | p. 79 |
| Drug-Nutrient Interactions | p. 82 |
| Conclusions | p. 82 |
| Suggested Reading | p. 84 |
| References | p. 84 |
| Ethical Issues of Infectious Disease Interventions | p. 87 |
| Key Points | p. 87 |
| Introduction | p. 87 |
| Elements of Ethics | p. 88 |
| Everyday Ethics | p. 90 |
| The Doctor-Patient Relationship | p. 91 |
| Goals of Care and Advance Care Plans | p. 91 |
| Interventions: Burdens and Benefits | p. 92 |
| Quality of Life | p. 93 |
| Health Promotion | p. 94 |
| Health-Care Decision Making | p. 94 |
| Role of the Interdisciplinary Team | p. 97 |
| Role of the Medical Director | p. 98 |
| Advanced Dementia | p. 98 |
| Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome | p. 99 |
| End-of-Life Care | p. 99 |
| Infection Control Practices | p. 100 |
| Cost Concerns | p. 100 |
| Research Issues | p. 101 |
| The Future | p. 101 |
| Suggested Reading | p. 102 |
| References | p. 102 |
| Principles of Managing Infections in Long-Term Care Facilities | |
| Clinical Manifestations of Infections | p. 105 |
| Key Points | p. 105 |
| Introduction | p. 106 |
| Atypical Presentations of Infection | p. 107 |
| Fever | p. 108 |
| Conclusion | p. 111 |
| Suggested Reading | p. 111 |
| References | p. 111 |
| Establishing an Infection Control Program | p. 115 |
| Key Points | p. 115 |
| Background | p. 116 |
| Unique Challenges to Infection Control | p. 116 |
| Regulatory Aspects of Infection Control | p. 118 |
| Components of Infection Control | p. 119 |
| Infection Control Practitioner | p. 127 |
| Review Committee | p. 127 |
| Resources for Infection Control Practitioners and Suggested Reading | p. 128 |
| References | p. 128 |
| Epidemiologic Investigation of Infectious Disease Outbreaks in Long-Term Care Facilities | p. 131 |
| Key Points | p. 131 |
| Introduction | p. 132 |
| Characteristics of Long-Term Care Facilities | p. 132 |
| Risk Factors for Outbreaks in LTCFs | p. 133 |
| Key Aspects of Infectious Disease Outbreak Investigation | p. 134 |
| Selected Infectious Disease Outbreaks | p. 141 |
| Conclusions | p. 145 |
| Suggested Reading | p. 146 |
| References | p. 146 |
| An Approach to Antimicrobial Therapy | p. 149 |
| Key Points | p. 149 |
| General Issues of Antimicrobial Therapy | p. 149 |
| Optimizing the Use of Antimicrobial Agents in the LTCF | p. 151 |
| Drug Factors to Consider in Prescribing Antimicrobial Therapy | p. 155 |
| Potentially Useful and Safe Antimicrobial Agents for LTCF Residents | p. 159 |
| Suggested Reading | p. 164 |
| References | p. 164 |
| Common Infections in Long- Term Care Facilities | |
| Urinary Tract Infection | p. 169 |
| Key Points | p. 169 |
| Introduction | p. 170 |
| Epidemiology and Clinical Relevance | p. 170 |
| Clinical Manifestations | p. 175 |
| Diagnostic Approach | p. 177 |
| Therapeutic Interventions | p. 180 |
| Infection Control Measures | p. 184 |
| Prevention | p. 185 |
| Suggested Reading | p. 187 |
| References | p. 187 |
| Influenza and Other Respiratory Viruses | p. 191 |
| Key Points | p. 191 |
| Introduction | p. 192 |
| Influenza | p. 192 |
| Respiratory Syncytial Virus | p. 201 |
| Parainfluenza | p. 204 |
| Coronavirus | p. 206 |
| Rhinovirus | p. 208 |
| Human Metapneumovirus | p. 209 |
| Suggested Reading | p. 210 |
| References | p. 210 |
| Pneumonia and Bronchitis | p. 215 |
| Key Points | p. 215 |
| Nursing Home-Associated Pneumonia | p. 215 |
| Bronchitis | p. 228 |
| Suggested Reading | p. 229 |
| References | p. 229 |
| Tuberculosis | p. 233 |
| Key Points | p. 233 |
| Introduction | p. 233 |
| Epidemiology and Clinical Significance | p. 234 |
| Pathogenesis | p. 235 |
| Clinical Manifestations | p. 236 |
| Diagnosis | p. 236 |
| Treatment | p. 237 |
| Prevention | p. 244 |
| Infection Control | p. 244 |
| Suggested Reading | p. 247 |
| References | p. 247 |
| Infected Pressure Ulcers | p. 251 |
| Key Points | p. 251 |
| Epidemiology and Clinical Relevance | p. 252 |
| Pathogenesis of Infected Pressure Ulcers | p. 257 |
| Clinical Manifestations | p. 258 |
| Diagnostic Approach | p. 259 |
| Therapeutic Interventions | p. 264 |
| Infection Control Measures | p. 270 |
| Prevention | p. 272 |
| Suggested Reading | p. 274 |
| References | p. 274 |
| Herpes Zoster, Cellulitis, and Scabies | p. 277 |
| Key Points | p. 277 |
| Herpes Zoster | p. 278 |
| Cellulitis | p. 284 |
| Scabies | p. 290 |
| Suggested Reading | p. 295 |
| References | p. 295 |
| Infectious Diarrhea | p. 297 |
| Key Points | p. 297 |
| Epidemiology and Clinical Relevance | p. 298 |
| Clinical Manifestations | p. 300 |
| Diagnostic Approach | p. 301 |
| Therapeutic Intervention | p. 305 |
| Infection Control Measures | p. 307 |
| Prevention | p. 308 |
| Suggested Reading | p. 308 |
| References | p. 308 |
| Hepatitis in Long-Term Care Facilities | p. 311 |
| Key Points | p. 311 |
| Introduction | p. 311 |
| Epidemiology and Clinical Relevance | p. 312 |
| Clinical Manifestations and Complications of Viral Hepatitis | p. 320 |
| Therapeutic Interventions | p. 323 |
| Infection Control and Prevention | p. 326 |
| Conclusion | p. 331 |
| Suggested Reading | p. 332 |
| References | p. 332 |
| Conjunctivitis, Otitis, and Sinusitis | p. 335 |
| Key Points | p. 335 |
| Conjunctivitis | p. 336 |
| Otitis Media | p. 338 |
| Otitis Externa | p. 340 |
| Sinusitis | p. 342 |
| Suggested Reading | p. 345 |
| References | p. 345 |
| Human Immunodeficiency Virus Infection in the Nursing Home | p. 349 |
| Key Points | p. 349 |
| Introduction | p. 349 |
| General Epidemiology | p. 350 |
| Epidemiology in Older Adults | p. 352 |
| Long-Term Care Facilities | p. 356 |
| Pathogenesis of HIV in the Elderly | p. 358 |
| Clinical Issues in Nursing Home AIDS Residents | p. 359 |
| Treatment of HIV Infection in the Nursing Home | p. 361 |
| Psychosocial Concerns and Prevention | p. 366 |
| Suggested Reading | p. 367 |
| References | p. 367 |
| Vaccinations | p. 369 |
| Key Points | p. 369 |
| Infection, Aging, and Immune Response | p. 370 |
| Vaccine Utilization in Long-Term Care Facilities | p. 370 |
| Efforts to Increase Vaccine Utilization | p. 371 |
| Influenza | p. 371 |
| Pneumococcal Disease | p. 376 |
| Varicella Vaccine | p. 386 |
| Vaccination of Health-Care Workers in LTCFs | p. 387 |
| Summary | p. 387 |
| Suggested Reading | p. 388 |
| References | p. 388 |
| Emerging and Drug-Resistant Pathogens | |
| Methicillin-Resistant Staphylococcus aureus | p. 391 |
| Key Points | p. 391 |
| Introduction | p. 392 |
| Epidemiology and Clinical Relevance | p. 392 |
| Clinical Manifestation | p. 396 |
| Diagnostic Approach | p. 398 |
| Therapeutic Interventions | p. 399 |
| Infection Control Measures | p. 400 |
| Prevention | p. 406 |
| Suggested Reading | p. 406 |
| References | p. 407 |
| Vancomycin (Glycopeptide)-Resistant Enterococci in the Long-Term Care Setting | p. 411 |
| Key Points | p. 411 |
| Epidemiology and Clinical Relevance | p. 411 |
| Clinical Manifestations | p. 415 |
| Diagnostic Approach | p. 416 |
| Therapeutic Interventions | p. 418 |
| Infection Control Measures | p. 419 |
| Prevention | p. 423 |
| Suggested Reading | p. 424 |
| References | p. 424 |
| Gram-Negative Bacteria | p. 427 |
| Key Points | p. 427 |
| Epidemiology and Clinical Relevance | p. 428 |
| Clinical Syndromes | p. 434 |
| Diagnostic Approach | p. 434 |
| Therapeutic Interventions | p. 435 |
| Prevention | p. 439 |
| Suggested Reading | p. 440 |
| References | p. 440 |
| Fungal Infections | p. 445 |
| Key Points | p. 445 |
| Introduction | p. 445 |
| Epidemiology and Clinical Relevance | p. 446 |
| Clinical Manifestations | p. 448 |
| Diagnostic Approach | p. 452 |
| Therapeutic Interventions | p. 455 |
| Infection Control Measures | p. 460 |
| Prevention | p. 461 |
| Suggested Reading | p. 462 |
| References | p. 462 |
| Severe Acute Respiratory Syndrome | p. 465 |
| Key Points | p. 465 |
| Introduction | p. 465 |
| SARS: Epidemiology and Clinical Relevance | p. 466 |
| Microbiology | p. 467 |
| Clinical Disease | p. 468 |
| Diagnosis | p. 469 |
| Treatment | p. 470 |
| Prevention | p. 471 |
| Suggested Reading | p. 471 |
| References | p. 471 |
| Important Source References | |
| Definitions of Common Infections in Long-Term Care Facilities | p. 473 |
| Conditions Applicable to Definitions | p. 473 |
| Respiratory Tract Infection | p. 473 |
| Urinary Tract Infection | p. 474 |
| Skin Infections | p. 475 |
| Gastrointestinal Tract Infection | p. 475 |
| Comments | p. 476 |
| Guide to Evaluating Fever and Infection in Long-Term Care Facilities | p. 477 |
| Clinical Evaluation | p. 477 |
| Laboratory Tests | p. 478 |
| Indications for Transfer to an Acute Care Facility | p. 480 |
| Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term Care Facilities: Results of a Consensus Conference | p. 481 |
| Skin and Soft Tissue Infections | p. 481 |
| Respiratory Infections | p. 481 |
| Urinary Tract Infection | p. 482 |
| Fever in Which the Focus of Infection is Unknown | p. 483 |
| Index | p. 485 |
| About the Editors | p. 501 |
| Table of Contents provided by Ingram. All Rights Reserved. |
