BOOK
Infections in Older Adults, An Issue of Infectious Disease Clinics of North America, E-Book
Robin L.P. Jump | David H. Canaday
(2017)
Additional Information
Book Details
Abstract
With the expanding aging population in both the United States and worldwide, health issues associated with aging are major personal and public health concerns. Although cardiovascular diseases, cancers, strokes, dementia, pulmonary disease, and diabetes mellitus are listed as major causes of death in older adults, in many instances the final cause of demise is complications associated with infections. Dr. Jump and Dr. Canady have assembled top authors to present the current clinical knowledge on the following topics: Urinary Tract Infections; Clostrdium difficile; Wounds/SSTI; Influenza; Other Respiratory Viruses; HIV; Antimicrobial Stewardship for Older Adults; Antibiotics at the End of Life; Sepsis in Older Adults; Antimicrobial Therapy in Older Adults; Norovirus/Viral outbreaks; and Bone and Joint Infections. Readers should have a solid understanding of the current clinical information needed to effectively manage infections in older adults.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Infections in Older Adults | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Aging Has Unique Effects on the Risks, Presentation, Diagnosis, Treatment, and Prognosis of Infectious Diseases | vii | ||
| Influence of Aging and Environment on Presentation of Infection in Older Adults | vii | ||
| Antimicrobial Pharmacokinetics and Pharmacodynamics in Older Adults | vii | ||
| Antibiotic Stewardship in Nursing Facilities | vii | ||
| Antimicrobial Use at the End of Life | viii | ||
| Breaking the Chain of Infection in Older Adults: A Review of Risk Factors and Strategies for Preventing Device-Related Infe ... | viii | ||
| Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults | viii | ||
| Bacterial Pneumonia in Older Adults | viii | ||
| Septic Arthritis and Prosthetic Joint Infections in Older Adults | ix | ||
| Sepsis in Older Adults | ix | ||
| Clostridium difficile in Older Adults | ix | ||
| Influenza in Older Adults | ix | ||
| Respiratory Syncytial Virus and Other Noninfluenza Respiratory Viruses in Older Adults | x | ||
| Human Immunodeficiency Virus and Aging in the Era of Effective Antiretroviral Therapy | x | ||
| Herpes Zoster in the Older Adult | x | ||
| Hepatitis C Virus Infection in the Older Patient | x | ||
| Norovirus Infection in Older Adults: Epidemiology, Risk Factors, and Opportunities for Prevention and Control | xi | ||
| INFECTIOUS DISEASE CLINICS\rOF NORTH AMERICA\r\r | xii | ||
| FORTHCOMING ISSUES | xii | ||
| March 2018 | xii | ||
| June 2018 | xii | ||
| September 2018 | xii | ||
| RECENT ISSUES | xii | ||
| September 2017 | xii | ||
| March 2017 | xii | ||
| June 2017 | xii | ||
| Preface:\rAging Has Unique Effects on the Risks, Presentation, Diagnosis, Treatment, and Prognosis of Infectious Diseases | xiii | ||
| REFERENCES | xiv | ||
| Influence of Aging and Environment on Presentation of Infection in Older Adults | 593 | ||
| Key points | 593 | ||
| INTRODUCTION | 594 | ||
| PATHOPHYSIOLOGIC FACTORS INFLUENCING INFECTION RISK AND PRESENTATION IN OLDER ADULTS | 594 | ||
| Age-related Immune Changes | 595 | ||
| Age-related Organ-specific Physiologic Changes | 596 | ||
| Frailty | 598 | ||
| CLINICAL FACTORS INFLUENCING INFECTION RISK AND PRESENTATION IN OLDER ADULTS | 598 | ||
| Temperature Regulation | 598 | ||
| Cognitive Decline | 600 | ||
| Malnutrition | 601 | ||
| THE INFLUENCE OF THE LIVING ENVIRONMENT ON INFECTION RISK AND PRESENTATION IN OLDER ADULTS | 602 | ||
| SUMMARY | 604 | ||
| DISCLOSURE | 604 | ||
| ACKNOWLEDGMENTS | 605 | ||
| REFERENCES | 605 | ||
| Antimicrobial Pharmacokinetics and Pharmacodynamics in Older Adults | 609 | ||
| Key points | 609 | ||
| INTRODUCTION | 609 | ||
| PHARMACOKINETIC CHANGES IN THE ELDERLY | 610 | ||
| Absorption | 610 | ||
| Distribution | 611 | ||
| Metabolism | 611 | ||
| Elimination | 612 | ||
| PHARMACODYNAMIC MODELS | 612 | ||
| Time-Dependent Bacterial Killing | 613 | ||
| Concentration-Dependent Bacterial Killing | 613 | ||
| MODIFICATIONS IN DRUG DELIVERY BASED ON PHARMACODYNAMIC MODELS | 613 | ||
| Once-Daily Aminoglycoside Therapy | 614 | ||
| Prolonged Infusions | 614 | ||
| Lower, More Frequent Doses | 614 | ||
| SUMMARY | 615 | ||
| REFERENCES | 615 | ||
| Antibiotic Stewardship in Nursing Facilities | 619 | ||
| Key points | 619 | ||
| INTRODUCTION | 619 | ||
| FACTORS DRIVING ANTIBIOTIC USE IN NURSING FACILITIES | 620 | ||
| EFFECTS OF ANTIBIOTIC STEWARDSHIP INTERVENTIONS IN NURSING FACILITIES | 621 | ||
| Centralized Antibiotic Stewardship Interventions | 621 | ||
| Decentralized Antibiotic Stewardship Interventions | 623 | ||
| CURRENT STATE OF ANTIBIOTIC STEWARDSHIP PROGRAMS IN NURSING FACILITIES | 625 | ||
| EXPANDING ANTIBIOTIC STEWARDSHIP PROGRAMS IN NURSING FACILITIES | 625 | ||
| Leadership Commitment | 627 | ||
| Programmatic Structure (Accountability and Expertise) | 628 | ||
| Tracking and Reporting Antibiotic Utilization and Related Outcomes | 629 | ||
| Staff and Provider Education | 629 | ||
| Antibiotic Stewardship Program Improvement Activities | 630 | ||
| Antibiotic prescribing policies | 630 | ||
| Broad interventions | 630 | ||
| Pharmacy-driven interventions | 632 | ||
| Syndrome-specific interventions | 632 | ||
| FUTURE DIRECTIONS | 632 | ||
| REFERENCES | 633 | ||
| Antimicrobial Use at the End of Life | 639 | ||
| Key points | 639 | ||
| INTRODUCTION | 639 | ||
| PATIENT POPULATIONS AND POPULATION-SPECIFIC CONSIDERATIONS | 640 | ||
| GOALS OF ANTIMICROBIAL THERAPY | 641 | ||
| POTENTIAL BENEFITS OF ANTIMICROBIAL THERAPY | 642 | ||
| POTENTIAL HARMS OF ANTIMICROBIAL THERAPY | 642 | ||
| PROPOSED ALGORITHM FOR MANAGEMENT | 643 | ||
| SUMMARY | 644 | ||
| REFERENCES | 644 | ||
| Breaking the Chain of Infection in Older Adults | 649 | ||
| Key points | 649 | ||
| INTRODUCTION | 649 | ||
| HOST FACTORS | 650 | ||
| ENVIRONMENTAL FACTORS | 652 | ||
| PATHOGEN FACTORS | 653 | ||
| THE ROLE OF BIOFILMS | 653 | ||
| IMPACT OF INDWELLING DEVICES ON ANTIMICROBIAL USE | 653 | ||
| BREAKING THE LINKS | 654 | ||
| General Prevention Strategies for Reducing Device-Related Infections | 654 | ||
| Device Management | 654 | ||
| Surveillance and Device Removal | 655 | ||
| Horizontal Versus Vertical Approaches to Infection Prevention | 655 | ||
| Standard Precautions and Hand Hygiene | 656 | ||
| Contact Precautions | 656 | ||
| Bundled Approaches | 656 | ||
| Environmental Cleaning | 657 | ||
| Antimicrobial Stewardship | 657 | ||
| Targeting Specific Device-Related Infections | 657 | ||
| Urinary catheters | 658 | ||
| Central venous catheters | 659 | ||
| Percutaneous feeding tubes | 660 | ||
| The “Quest for Zero” | 661 | ||
| Resource Constraints and Economic Considerations | 661 | ||
| SUMMARY | 662 | ||
| REFERENCES | 662 | ||
| Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults | 673 | ||
| Key points | 673 | ||
| INTRODUCTION | 673 | ||
| EPIDEMIOLOGY, MICROBIOLOGY, AND PATHOGENESIS OF URINARY TRACT INFECTIONS | 674 | ||
| Epidemiology | 674 | ||
| Microbiology | 675 | ||
| Pathogenesis | 675 | ||
| DEFINING CLINICAL AND LABORATORY CRITERIA FOR URINARY TRACT INFECTION | 676 | ||
| QUALITY AND INTERPRETATION OF URINE SPECIMEN COLLECTION | 679 | ||
| TREATMENT OF URINARY TRACT INFECTIONS | 680 | ||
| PREVENTION OF URINARY TRACT INFECTION | 682 | ||
| Effective Approaches to Catheter-Associated Urinary Tract Infection Prevention in Long-Term Care | 682 | ||
| Ineffective Approaches to Catheter-Associated Urinary Tract Infection Prevention | 682 | ||
| SUMMARY | 682 | ||
| REFERENCES | 683 | ||
| Bacterial Pneumonia in Older Adults | 689 | ||
| Key points | 689 | ||
| OVERVIEW AND EPIDEMIOLOGY | 689 | ||
| PATHOGENESIS: WHAT MAKES ELDERLY PATIENTS PRONE TO DEVELOPING PNEUMONIA? | 690 | ||
| DIFFERENT EPIDEMIOLOGIC CATEGORIES OF PNEUMONIA IN OLDER ADULTS | 691 | ||
| EPIDEMIOLOGY | 692 | ||
| Pneumonia Among Lon-term Care Facility Residents | 693 | ||
| MICROBIOLOGY | 693 | ||
| Common Causes of Pneumonia Among Elderly Patients in the Community, Including Long-term Care Facilities | 693 | ||
| Pneumonia Owing to less Common Pathogens, Including Multidrug-resistant Pathogens, Among Older Adults in the Community and ... | 696 | ||
| Gram-negative bacilli | 696 | ||
| Resistant Streptococcus pneumoniae | 696 | ||
| Staphylococcus aureus including methicillin-resistant Staphylococcus aureus | 696 | ||
| Risk factors for community-acquired pneumonia owing to multidrug-resistant organisms | 697 | ||
| CLINICAL PRESENTATION AND DIAGNOSIS | 697 | ||
| Imaging | 698 | ||
| Laboratory Evaluation | 699 | ||
| Microbiologic Diagnosis | 699 | ||
| MANAGEMENT | 700 | ||
| Site of Care | 700 | ||
| Antibiotic Treatment | 701 | ||
| Considerations in Community-acquired Pneumonia Treatment | 701 | ||
| Corticosteroids in Community-acquired Pneumonia | 703 | ||
| Other Considerations in the Management of Community-acquired Pneumonia in Elderly Patients | 704 | ||
| OUTCOMES | 704 | ||
| Outcomes of Pneumonia Among Residents of Long-term Care Facilities | 705 | ||
| SUMMARY | 705 | ||
| REFERENCES | 705 | ||
| Septic Arthritis and Prosthetic Joint Infections in Older Adults | 715 | ||
| Key points | 715 | ||
| INTRODUCTION | 715 | ||
| SEPTIC ARTHRITIS | 716 | ||
| Epidemiology | 716 | ||
| Burden | 716 | ||
| Risk factors | 716 | ||
| Clinical Manifestations | 716 | ||
| Pathogenesis | 717 | ||
| Diagnosis | 718 | ||
| Management | 719 | ||
| Prevention | 719 | ||
| PROSTHETIC JOINT INFECTIONS | 719 | ||
| Epidemiology | 720 | ||
| Burden | 720 | ||
| Risk factors | 720 | ||
| Clinical Manifestations | 720 | ||
| Pathogenesis | 720 | ||
| Diagnosis | 722 | ||
| Management | 723 | ||
| Prevention and Suppression | 724 | ||
| SUMMARY | 725 | ||
| REFERENCES | 725 | ||
| Sepsis in Older Adults | 731 | ||
| Key points | 731 | ||
| INTRODUCTION | 731 | ||
| EPIDEMIOLOGY | 731 | ||
| SUSCEPTIBILITY TO INFECTION | 732 | ||
| DIAGNOSTIC CHALLENGES | 733 | ||
| CAUSE | 734 | ||
| MANAGEMENT | 734 | ||
| Antimicrobial Selection and Dosage | 734 | ||
| Sedation and Delirium | 736 | ||
| OUTCOMES | 736 | ||
| Mortality | 736 | ||
| Functional Status and Cognitive Impairment | 737 | ||
| Postacute Care | 737 | ||
| GOALS OF CARE | 737 | ||
| Cost Burden of Sepsis in the Elderly | 738 | ||
| SUMMARY | 738 | ||
| REFERENCES | 738 | ||
| Clostridium difficile in Older Adults | 743 | ||
| Key points | 743 | ||
| INTRODUCTION | 743 | ||
| PATHOGENESIS | 744 | ||
| ASYMPTOMATIC CARRIAGE OF TOXIGENIC CLOSTRIDIUM DIFFICILE | 745 | ||
| EPIDEMIOLOGY | 746 | ||
| CLINICAL PRESENTATION | 747 | ||
| DIAGNOSIS | 748 | ||
| MANAGEMENT | 749 | ||
| FECAL MICROBIOTA TRANSPLANTATION | 751 | ||
| IMMUNE-BASED APPROACHES TO REDUCE RECURRENCE OF CLOSTRIDIUM DIFFICILE INFECTION | 752 | ||
| SUMMARY | 753 | ||
| ACKNOWLEDGMENTS | 753 | ||
| REFERENCES | 753 | ||
| Influenza in Older Adults | 757 | ||
| Key points | 757 | ||
| INTRODUCTION | 757 | ||
| VIROLOGY | 757 | ||
| EPIDEMIOLOGY OF INFLUENZA | 758 | ||
| CLINICAL PRESENTATION | 758 | ||
| DIAGNOSIS | 758 | ||
| TREATMENT | 759 | ||
| PREVENTION | 760 | ||
| Vaccination | 760 | ||
| Herd Protection | 761 | ||
| Antiviral Medications | 763 | ||
| SUMMARY | 763 | ||
| REFERENCES | 763 | ||
| Respiratory Syncytial Virus and Other Noninfluenza Respiratory Viruses in Older Adults | 767 | ||
| Key points | 767 | ||
| INTRODUCTION | 768 | ||
| Human Immunodeficiency Virus and Aging in the Era of Effective Antiretroviral Therapy | 791 | ||
| Key points | 791 | ||
| AGING WITH HUMAN IMMUNODEFICIENCY VIRUS | 791 | ||
| MECHANISMS OF AGING | 792 | ||
| Genetic Instability | 792 | ||
| Immunosenesence | 793 | ||
| Impaired Cellular Regeneration | 793 | ||
| Inflammation | 794 | ||
| DEREGULATED NUTRIENT SENSING | 794 | ||
| AGE-ASSOCIATED COMORBIDITIES AND HUMAN IMMUNODEFICIENCY VIRUS: CURRENT KNOWLEDGE OF EPIDEMIOLOGY AND MECHANISMS | 794 | ||
| Cardiovascular Disease | 794 | ||
| Malignancy | 795 | ||
| Kidney Disease | 796 | ||
| Liver Disease | 796 | ||
| Neurocognitive Impairment | 797 | ||
| GERIATRIC SYNDROMES AND FRAILTY | 797 | ||
| Bone Disease | 798 | ||
| CLINICAL IMPLICATIONS | 798 | ||
| SUMMARY | 799 | ||
| REFERENCES | 799 | ||
| Herpes Zoster in the Older Adult | 811 | ||
| Key points | 811 | ||
| INTRODUCTION | 811 | ||
| EPIDEMIOLOGY | 811 | ||
| PATHOGENESIS | 812 | ||
| CLINICAL FEATURES | 812 | ||
| POSTZOSTER SEQUELAE | 814 | ||
| Postherpetic Neuralgia | 814 | ||
| Secondary Bacterial Infection | 814 | ||
| Other Dermatologic Complications | 815 | ||
| Residual Neurologic Manifestations of Varicella Zoster Virus | 815 | ||
| Varicella Zoster Virus Vasculopathy | 815 | ||
| DIAGNOSIS | 815 | ||
| TREATMENT | 816 | ||
| Antiviral Agents | 816 | ||
| Corticosteroids | 819 | ||
| Analgesics | 819 | ||
| Tricyclic Antidepressants | 820 | ||
| Gabapentin/Pregabalin | 820 | ||
| Topical Therapy | 820 | ||
| Regional or Local Anesthetic Nerve Blocks | 820 | ||
| Herpes Zoster Ophthalmicus Therapy | 821 | ||
| PREVENTION | 821 | ||
| CURRENT DEVELOPMENTS | 821 | ||
| REFERENCES | 823 | ||
| Hepatitis C Virus Infection in the Older Patient | 827 | ||
| Key points | 827 | ||
| INTRODUCTION | 827 | ||
| EPIDEMIOLOGY AND SCREENING OF HEPATITIS C VIRUS INFECTION IN THE UNITED STATES | 828 | ||
| NATURAL HISTORY AND CLINICAL COURSE OF HEPATITIS C VIRUS INFECTION AND THE IMPACT OF AGE | 829 | ||
| HEPATITIS C VIRUS INFECTION AND EXTRAHEPATIC CLINICAL OUTCOMES | 830 | ||
| Hepatitis C Virus Infection and Malignancy | 831 | ||
| Hepatitis C Virus Infection and Kidney Disease | 832 | ||
| Hepatitis C Virus Infection and Diabetes | 832 | ||
| Hepatitis C Virus Infection and Cardiovascular Disease | 832 | ||
| Hepatitis C Virus and Neuropsychological and Neurocognitive Effects | 832 | ||
| HEPATITIS C VIRUS TREATMENT IN THE OLDER PATIENT WITH HEPATITIS C VIRUS INFECTION | 833 | ||
| SUMMARY | 834 | ||
| REFERENCES | 834 | ||
| Norovirus Infection in Older Adults | 839 | ||
| Key points | 839 | ||
| BACKGROUND | 839 | ||
| VIROLOGY AND VIRAL DIVERSITY | 840 | ||
| CLINICAL PRESENTATION AND DISEASE COURSE | 840 | ||
| Clinical Symptoms and Severity of Norovirus in Older Adults (Greater Than or Equal to 65 Years of Age) | 841 | ||
| Prolonged Infection and Complications in the Immunocompromised | 841 | ||
| VIRAL SHEDDING AND TRANSMISSION | 842 | ||
| IMMUNITY | 843 | ||
| DIAGNOSIS | 844 | ||
| TREATMENT | 846 | ||
| ENDEMIC DISEASE | 847 | ||
| OUTBREAKS | 854 | ||
| Long-term Care Facility Outbreaks | 854 | ||
| Hospital Outbreaks | 854 | ||
| PREVENTION AND CONTROL OF NOROVIRUS OUTBREAKS IN HEALTH CARE SETTINGS | 860 | ||
| Patient Cohorting and Isolation Precautions | 860 | ||
| Staff Precautions, Hand Hygiene, and Personal Protective Equipment | 860 | ||
| Patient Transfer and Ward Closure | 861 | ||
| Environmental Cleaning | 861 | ||
| VACCINE PROSPECTS | 861 | ||
| SUMMARY | 862 | ||
| REFERENCES | 862 |