title: Age and other risk factors of pneumonia among residents of Polish long-term care facilities.
abstract: BACKGROUND
  Pneumonia is one of the leading causes of morbidity and mortality in the elderly population. Nursing home-acquired pneumonia (NHAP) is probably the largest health problem in long-term care facilities (LTCFs). It is the second most common infection in LTCFs and frequently requires hospitalization. The aim of this study was to investigate the incidence rate of NHAP among LTCF residents, its microbial etiology, and the frequency of multidrug-resistant microorganisms. Risk factors for NHAP were analyzed.
  
  
  METHODS
  This was a prospective study conducted on a group of 217 elderly subjects aged ≥65 years, recruited from the inhabitants of LTCFs, with disabled elderly individuals living in the community serving as controls. Continuous surveillance was carried out from December 1, 2009 to November 30, 2010.
  
  
  RESULTS
  The incidence rate of NHAP in the observed population of Polish residents was 0.6/1000 resident-days. Vulnerability to NHAP was due to the poor general condition of residents, expressed by low Barthel index values (relative risk (RR) 1.6), the activities of daily living (ADL) score (RR 1.7), the Katz scale (RR 1.2), and limited physical activity (RR 1.6). Also significant were malnutrition (RR 2.3), the use of a bladder catheter (RR 1.3), dysphagia (RR 1.7), tracheotomy tube (RR 3.1), and gastric feeding tube (RR 3.5). Enterobacteriaceae were the predominant etiological agents of NHAP (56.3%).
  
  
  CONCLUSIONS
  The significance of risk factors for NHAP among residents in LTCFs was confirmed. Unfortunately, we also found that a lack of proper supervision with regard to the microbiology of infections is characteristic of Polish health care and LTCFs. There is an opportunity to improve the medical care of patients with severe disabilities, limit the rise in antimicrobial resistance and the need for hospitalization, and improve the prognosis.
authors.affiliation: Department of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, 31-121 Krakow, Poland. mbmach@cyf-kr.edu.pl
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Wójkowska-Mach
authors.forename: Barbara
authors.initials: B
authors.lastname: Gryglewska
authors.forename: Dorota
authors.initials: D
authors.lastname: Romaniszyn
authors.forename: Joanna
authors.initials: J
authors.lastname: Natkaniec
authors.forename: Monika
authors.initials: M
authors.lastname: Pobiega
authors.forename: Paweł
authors.initials: P
authors.lastname: Adamski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzicki
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kubicz
authors.forename: Piotr B
authors.initials: PB
authors.lastname: Heczko
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors