Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-28T17:30:39.670Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  02 January 2015

Nimalie D. Stone*
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Muhammad S. Ashraf
Affiliation:
East Carolina University, Greenville, North Carolina
Jennifer Calder
Affiliation:
New York Medical College, Valhalla, New York
Christopher J. Crnich
Affiliation:
University of Wisconsin and William S. Middleton VA Medical Center, Madison, Wisconsin
Kent Crossley
Affiliation:
University of Minnesota and Minneapolis VA Medical Center, Minneapolis, Minnesota
Paul J. Drinka
Affiliation:
Medical College of Wisconsin, Milwaukee, Wisconsin
Carolyn V. Gould
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Manisha Juthani-Mehta
Affiliation:
Yale University School of Medicine, New Haven, Connecticut
Ebbing Lautenbach
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Mark Loeb
Affiliation:
McMaster University, Hamilton, Ontario, Canada
Taranisia MacCannell
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Preeti N. Malani
Affiliation:
University of Michigan Medical School, Ann Arbor, Michigan Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
Lona Mody
Affiliation:
University of Michigan Medical School, Ann Arbor, Michigan Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
Joseph M. Mylotte
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia East Carolina University, Greenville, North Carolina
Lindsay E. Nicolle
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia New York Medical College, Valhalla, New York
Mary-Claire Roghmann
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia University of Wisconsin and William S. Middleton VA Medical Center, Madison, Wisconsin
Steven J. Schweon
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia University of Minnesota and Minneapolis VA Medical Center, Minneapolis, Minnesota
Andrew E. Simor
Affiliation:
University of Toronto School of Medicine, Toronto, Ontario, Canada
Philip W. Smith
Affiliation:
University of Nebraska Medical Center, Omaha, Nebraska
Kurt B. Stevenson
Affiliation:
Ohio State University Hospitals, Columbus, Ohio
Suzanne F. Bradley
Affiliation:
University of Michigan Medical School, Ann Arbor, Michigan Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
*
1600 Clifton Road NE, DHQP/CDC, Mailstop A-31, Atlanta, GA 30333 (nstone@cdc.gov)

Abstract

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.

Infect Control Hosp Epidemiol 2012;33(10):965-977

Type
SHEA/CDC Position Paper
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.McGeer, A, Campbell, B, Emori, TG, et al.Definitions of infection surveillance in long-term care facilities. Am J Infect Control 1991;19:17.CrossRefGoogle ScholarPubMed
2.Peppier, C, Campbell, B, Prince, K, Rivera, A, Scully, D; Cooperative Infection Control Committee. A surveillance protocol for long term-care facilities. Markham, Ontario, Canada: Ontario Nursing Home Association, 1988:814.Google Scholar
3.Umscheid, CA, Agarwal, RK, Brennan, PJ; Healthcare Infection Control Practices Advisory Committee. Updating the guideline development methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC). Am J Infect Control 2010;38:264273.CrossRefGoogle ScholarPubMed
4.High, K, Bradley, SF, Gravenstein, S, et al.Clinical practice guideline for the evaluation of fever and infection in older adult residents of long term care facilities. Clin Infect Dis 2009;48: 149171.CrossRefGoogle ScholarPubMed
5.Loeb, M, Bentley, DW, Bradley, S, et al.Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: results of a consensus conference. Infect Control Hosp Epidemiol 2001;22:120124.CrossRefGoogle ScholarPubMed
6.Schwartz, B, Ussery, XT. Group A streptococcal outbreaks in nursing homes. Infect Control Hosp Epidemiol 1992;13:742747.CrossRefGoogle Scholar
7.Centers for Disease Control and Prevention. Transmission of hepatitis B virus among persons undergoing blood glucose monitoring in long-term-care facilities: Mississippi, North Carolina, and Los Angeles County, California, 2003-2004. Morb Mortal Wkly Rep 2005;54:220223.Google Scholar
8.Mylotte, JM. Surveillance for Clostridium difficile-associated diarrhea in long-term care facilities: what you get is not what you see. Infect Control Hosp Epidemiol 2008;29:760763.CrossRefGoogle Scholar
9.Rothan-Tondeur, M, Piette, F, Lejeune, B, de Wazieres, B, Gavazzi, G. Infections in nursing homes: is it time to revise the McGeer criteria? J Am Geriatr Soc 2010;58:199201.CrossRefGoogle ScholarPubMed
10.Castle, SC, Yeh, M, Toledo, S, Yoshikawa, TT, Norman, DC. Lowering the temperature criterion improves detection of infections in nursing home residents. Aging Immunol Infect Dis 1993;4: 6776.Google Scholar
11.Roghmann, M-C, Warner, J, Mackowiak, PA. The relationship between age and fever magnitude. Am J Med Sci 2001;322:6870.CrossRefGoogle ScholarPubMed
12.Mehr, DR, Binder, EF, Kruse, RL, Zweig, SC, Madsen, RW, D'Agostino, RB. Clinical findings associated with radiographic pneumonia in nursing home residents. J Fam Pract 2001;50: 931937.Google ScholarPubMed
13.Lim, WS, MacFarlane, JT. A prospective comparison of nursing home acquired pneumonia with community acquired pneumonia. Eur Respir J 2001;18:362368.CrossRefGoogle ScholarPubMed
14. Minimum Data Set, version 3.0. Nursing Home Comprehensive (NC), version 1.00.2 10/01/2010, section C, p. 7.Google Scholar
15.Inouye, SK, van Dyck, CH, Alessi, CA, Balkin, S, Siegal, AP, Horwitz, RI. Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med 1990; 113:941948.CrossRefGoogle Scholar
16. Minimum Data Set, version 3.0. Nursing Home Comprehensive (NC), version 1.00.2 10/01/2010, Section G, p. 14.Google Scholar
17. The 2009 H1N1 pandemic: summary highlights, April 2009-April 2010. Centers for Disease Control and Prevention website. http://www.cdc.gOv/h1n1flu/cdcresponse.htm.Google Scholar
18.Ackerman, R, Waldron, RL. Difficulty breathing: agreement of paramedic and emergency physician diagnoses. Prehosp Emerg Care 2006;10:7780.CrossRefGoogle ScholarPubMed
19.Orr, PH, Nicolle, LE, Duckworth, H, et al.Febrile urinary infection in the institutionalized elderly. Am J Med 1996;100:7177.CrossRefGoogle ScholarPubMed
20.Loeb, M, Brazil, K, Lohfeld, L, et al.Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomized controlled trial. Br Med J 2006;351:669671.Google Scholar
21.Juthani-Mehta, M, Quagliarello, V, Perrelli, E, Towle, V, Van Ness, P, Tinetti, M. Clinical features to identify urinary tract infection in nursing home residents: a cohort study. J Am Geriatr Soc 2009;57:963970.CrossRefGoogle ScholarPubMed
22.Nicolle, LE. Symptomatic urinary tract infection in nursing home residents. J Am Geriatr Soc 2009;57:11131114.CrossRefGoogle ScholarPubMed
23.Weld, KJ, Dmochowski, RR. Effect of bladder management on urological complications in spinal cord injured patients. J Urol 2000;163:768772.CrossRefGoogle ScholarPubMed
24.Ouslander, JG, Schapira, M, Schnelle, JF. Urine specimen collection from incontinent female nursing home residents. J Am Geriatr Soc 1995;43:2;7981.CrossRefGoogle ScholarPubMed
25.Hooton, TM, Bradley, SF, Cardenas, DD, et al.Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clin Infect Dis 2010;50:625663.CrossRefGoogle ScholarPubMed
26.Tenney, JH, Warren, JW. Long term catheter-associated bacteriuria: species at low concentration. Urology 1987;30:444446.CrossRefGoogle ScholarPubMed
27.Horan, TC, Andrus, M, Dudeck, MA. NHSN definitions: CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309332.CrossRefGoogle ScholarPubMed
28.Cahill, CK, Rosenberg, J MD, Schweon, SJ, Smith, PW, Nicolle, LE. Scabies surveillance, prevention, and control. Ann Long-Term Care 2009;17:3135.Google Scholar
29.Laube, S. Skin infections and ageing. Ageing Res Rev 2004;3: 6989.CrossRefGoogle ScholarPubMed
30.Said, MA, Perl, TM, Sears, CL. Gastrointestinal flu: norovirus in health care and long-term care facilities. Clin Infect Dis 2008; 47:12021208.CrossRefGoogle ScholarPubMed
31.Simor, AE, Bradley, SF, Strausbaugh, LJ, Crossley, K, Nicolle, LE; SHEA Long-Term-Care Committee. SHEA Position Paper: Clostridium difficile in long-term-care facilities for the elderly. Infect Control Hosp Epidemiol 2002;23:696703.CrossRefGoogle ScholarPubMed
32.Simor, AE. Diagnosis, management, and prevention of Clostridium difficile infection in long-term care facilities: a review. J Am Geriatr Soc 2010;58:15561564.CrossRefGoogle ScholarPubMed
33.McDonald, LC, Coignard, B, Dubberke, E, et al.Recommendations for surveillance of Clostridium difficile-associated disease. Infect Control Hosp Epidemiol 2007;28:140145.CrossRefGoogle ScholarPubMed
34.Lopman, BA, Reacher, MH, Vipond, IB, Sarangi, J, Brown, DWG. Clinical manifestations of norovirus gastroenteritis in health care settings. Clin Infect Dis 2004;39:318324.CrossRefGoogle ScholarPubMed
35.Kaplan, JE, Gary, GW, Baron, RC, et al.Epidemiology of Norwalk gastroenteritis and the role of Norwalk virus in outbreaks of acute nonbacterial gastroenteritis. Ann Intern Med 1982;96: 756761.CrossRefGoogle ScholarPubMed
36.Turcios, RM, Widdowson, M-A, Sulka, AC, Mead, PS, Glass, RI. Reevaluation of epidemiologic criteria for identifying outbreaks of acute gastroenteritis due to norovirus: United States, 1998-2000. Clin Infect Dis 2006;42:964969.CrossRefGoogle ScholarPubMed
37.Mylotte, JM. Nursing home-acquired bloodstream infection. Infect Control Hosp Epidemiol 2005;26:833837.Google ScholarPubMed
38.Nicolle, LE, McIntyre, M, Hoban, D, Murray, D. Bacteremia in a long term care facility. Can J Infect Dis 1994;5:130132.Google ScholarPubMed
39.Richardson, JP, Hricz, L. Risk factors for the development of bacteremia in nursing home patients. Arch Earn Med 1995;4: 785789.Google ScholarPubMed
40.Raz, R, Ben-Israel, Y, Gronich, D, Granot, E, Colodner, R, Visotzky, I. Usefulness of blood cultures in the management of febrile patients in long-term care facilities. Eur J Clin Miaobiol Infect Dis 2005;24:745748.CrossRefGoogle ScholarPubMed