Infections resulting in diarrhea are common in nursing homes and other long-term care facilities. In the May 2010 "Journal of the American Medical Directors Association," Dr. Laurie Archbald-Pannone and colleagues say, "Long-term care facilities residents have been estimated to have the highest incidence of diarrheal illness among adults living in the developed world." Easily spread from patient to patient in long-term care facilities, diarrheal infections--both bacterial and viral--present serious health problems in the elderly and can result in death.
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Noroviruses, infectious viral conditions, cause inflammation in the lining of the stomach and intestines, often resulting in diarrhea and vomiting. They are the most common type of diarrhea-causing illnesses in the elderly. Other names for norovirus include stomach flu, viral gastroenteritis, Norwalk-like virus and food poisoning. Norovirus outbreaks occur in areas with close living and eating facilities, including nursing homes and cruise ships. Norovirus spreads through contact with infected persons or contaminated food.
Clostridium difficile, or C. diff, is a bacteria that causes infection resulting in severe, watery diarrhea, fever, abdominal pain and loss of appetite. It can lead to more serious complications including colitis, which is inflammation of the large intestine; sepsis, which is large amounts of bacteria in the bloodstream; and death. The infection usually occurs in individuals who have undergone prolonged use of antibiotics or have weakened immune systems. The elderly and those requiring long hospital or nursing home stays are at greatest risk. The disease spreads through contact with feces and infected surfaces. Because it is highly contagious, C. diff presents a problem in hospitals and long-term care facilities.
Escherichia coli, or E. coli, causes gastroenteritis resulting in vomiting and diarrhea. The initial bacterial infection usually comes from food or drinking water contamination. Once E. coli infects a person, he can easily spread the infection to others. In some cases an infection with E. coli can result in life-threatening complications.
The bacteria salmonella causes diarrheal infection. People in nursing homes generally acquire salmonella through contact with contaminated food. In the May 2009 "Journal of the American Medical Directors Association," Dr. Karl E. Steinberg and colleagues say, "Salmonella gastroenteritis accounts for just under 20 percent of institutionalized cases of gastroenteritis." Infection with salmonella can cause fever, diarrhea and stomach cramping. Once infected with salmonella, a person can spread the infection to others. Salmonella infections in elderly persons are very serious and can result in death.
The shigella bacteria can lead to diarrheal infection. As with salmonella, people acquire shigella through contact with contaminated food. Infected persons can easily transmit the infection to others. Symptoms of infection with shigella include bloody diarrhea, stomach cramps and fever.
MRSA, or methicillin-resistant Staphylococcus aureus, is a bacteria resistant to or not affected by the types of antibiotics normally used to treat staph infections. While most MRSA infections affect the skin, persons with weakened immune systems such as those in nursing homes can acquire MRSA in the intestinal tract. This type of infection could result in diarrheal illness. MRSA is spread by those already infected or colonized with it and is common in hospitals and nursing homes.
REFERENCES & RESOURCES
- "Age and Ageing"; Types of Infectious Outbreaks and Their Impacts on Elderly Care Facilities: A Review of the Literature; Momoe Utsumi, Kiyoko Makimoto, Nahid Quroshi and Nobuyuki Ashida; May 2010
- Centers for Disease Control and Prevention: Norovirus: Q & A
- "Journal of the American Medical Directors Association"; Diarrhea, Clostridium Difficile, and Intestinal Inflammation in Residents of a Long-Term Care Facility; Laurie Archbald-Pannone, MD, Jesus Emmanuel Sevilleja, MD, and Richard Guerrant, MD; May 2010
- "Journal of the American Medical Directors Association"; Diarrhea in Long-Term Care: A Messy Problem; John E. Morley and Karl E. Steinberg, MD; May 2009
- Centers for Disease Control and Prevention: Shigellosis
- Centers for Disease Control and Prevention: Viral Gastroenteritis