Nursing Home Pneumonia Infection

Nursing homes are intended to be safe environments for the elderly to live in and to be cared for, yet in many cases there are health concerns that can be created or exacerbated after an older person becomes a resident of a managed care facility. Nursing home pneumonia infections are the most common complications that nursing home residents develop, especially due to heightened risk factors like advanced age, dementia, or weakened immune systems from pre-existing conditions.

Incidence Rate and Causes

Nursing home pneumonia infections, often referred to as nursing home-acquired pneumonia or NHAP, occur anywhere from 0.3 to 2.3 times for every 1,000 nursing home care days according to the National Institutes of Health. NHAP is routinely caused by the same sorts of bacterial infections as community-acquired pneumonia, including bacterial influenza, Streptococcus pneumoniae and Moraxella catarrhalis, all of which are common bronchial bacterial infections. With the less robust health of most nursing home residents making pneumonia infections highly dangerous in many cases as one of the main symptoms is difficulty breathing, managing and diagnosing an NHAP infection as promptly as possible is essential to patient health.

NHAP is one of the most dangerous causes of morbidity and mortality in nursing home residents, with the American Academy of Family Physicians (AAFP) estimating that 30-day mortality rates can be as high as 30 percent in some cases. In some cases, NHAP can develop from exposure to an antibiotic-resistant strain of staph such as MRSA (Methicillin-resistant Staphylococcus aureus) that is often encountered in nursing homes and hospitals. MRSA is becoming an increased threat as a vector for pneumonia, as one recent scientific study found that antibiotic-resistant staph strain infection rates ranged from around 25 percent to 75 percent according to the AAFP.

Treatment and Prevention

With most nursing home pneumonia infections arising from bacterial sources, one of the most effective treatments is through administering antibiotic medication. There’s little to no evidence that shows NHAP is treated better by specific antibiotics except in cases where it has been confirmed that the pneumonia is a result of MRSA. In these cases, specific antibiotics that are known or suspected to still have an effect on MRSA infections are routinely used. MRSA infections on their own can be highly dangerous if they go unchecked, especially in the event that the bacteria, which usually causes skin infections, travels deeper into the body to attack the organs and the joints through the bloodstream.

Preventing NHAP infections in nursing homes before they take hold is often done by administering an influenza vaccination, as older patients with the flu have a heightened chance of developing pneumonia as a bacterial superinfection. While the flu shot doesn’t provide complete protection from the kinds of bacteria that can lead to an NHAP diagnosis, many nursing homes will have flu vaccinations administered to residents in the event of an influenza breakout as a preventative measure. Pneumococcal vaccinations are also one way that managed care facilities attempt to protect their residents from one of the more common bacteria that can cause NHAP. In the case of reducing the possibility of a MRSA colonization in a nursing home, more stringent disinfecting protocols are usually necessary – especially since most manage care facilities lack the kinds of facilities that a hospital has to manage infection and contamination response, as well as staff that are usually less experienced in preventing and containing bacterial outbreaks than individuals working in a hospital environment.

Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2262163/

http://emedicine.medscape.com/article/234916-overview

http://www.aafp.org/afp/2009/0601/p976.html