Пневмонии в домах престарелых: современный взгляд на проблему | КМАХ

Пневмонии в домах престарелых: современный взгляд на проблему

Клиническая Микробиология и Антимикробная Химиотерапия. 2007; 9(1):4-19

​ Синопальников А.И., Андреева И.В., Стецюк О.У.
пневмония пожилые эпидемиология антибактериальная терапия профилактика
Раздел
Болезни и возбудители
Тип
Журнальная статья
Публикация
Клиническая Микробиология и Антимикробная Химиотерапия. 2007; 9(1):4-19

Аннотация

Пневмонии являются часто встречающимися инфекциями у пациентов, проживающих в домах престарелых и учреждениях длительного ухода, отличаются тяжёлым течением и высокой летальностью. Значительная распространённость этой нозологии, трудности диагностики и неудовлетворительные исходы лечения, наряду с прогнозируемым увеличением численности лиц, проживающих в домах престарелых, диктуют необходимость тщательного изучения данной проблемы для разработки эффективных мер профилактики и лечения. В обзоре представлены имеющиеся на сегодняшний день сведения о эпидемиологии, факторах риска, этиологии, патогенезе, особенностях клинической картины пневмонии у данной категории пациентов. Приведены подходы к диагностике и тактике ведения пожилых пациентов с пневмонией; рассмотрены современные рекомендации по антимикробной терапии; проанализированы подходы к специфической и неспецифической профилактике данной инфекции в домах престарелых и учреждениях длительного ухода.

  • 1. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcareassociated pneumonia. Am J Respir Crit Care Med 2005; 171:388-416.
  • 2. Артемьев З., Петелин Г. Родная газета. 2005; 4(90), полоса 29.
  • 3. Yoshikawa T.T. Pneumonia, UTI, and decubiti in the nursing home: optimal management. Geriatrics 1989; 44:32-4, 37-40, 43.
  • 4. Medina-Walpole A.M., Katz P.R. Nursing home-acquired pneumonia. J Am Geriatr Soc 1999; 47:1005-15.
  • 5. Muder R.R. Pneumonia in residents of long-term care facilities: epidemiology, etiology, management, and prevention. Am J Med 1998; 105:319-30.
  • 6. Mylotte J.M. Nursing home-acquired pneumonia: update on treatment options. Drugs Aging 2006; 23:377-90.
  • 7. Coleman P.R. Pneumonia in the long-term care setting: etiology, management, and prevention. J Gerontol Nurs 2004; 30:14-23; 54-5.
  • 8. Niederman M.S. Nosocomial pneumonia in the elderly patient. Chronic care facility and hospital considerations. Clin Chest Med 1993; 14:479-90.
  • 9. Quagliarello V., Ginter S., Han L., et al. Modifiable risk factors for nursing home-acquired pneumonia. Clin Infect Dis 2005; 40:1-6.
  • 10. Feldman C. Pneumonia in the elderly. Clin Chest Med 1999; 20:563-73.
  • 11. El Solh A.A., Sikka P., Ramadan F., et al. Etiology of severe pneumonia in the very elderly. Am J Respir Crit Care Med 2001; 163:645-51.
  • 12. El Solh A.A., Aquilina A.T., Dhillon R.S., et al. Impact of invasive strategy on management of antimicrobial treatment failure in institutionalized older people with severe pneumonia. Am J Respir Crit Care Med 2002; 166:1038-43.
  • 13. Alvarez S., Shell C.G., Woolley T.W., et al. Nosocomial infec­tions occurring in nursing home residents. J Gerontol 1988; 43:9-17.
  • 14. Peterson P.K., Stein D.J., Guay D., et al. Prospective study of lower respiratory tract infections in an extended-care nursing home program: potential role of oral ciprofloxacin. Am J Med 1988; 85:64-71.
  • 15. Marrie T.J., Durant H., Yates L. Community-acquired pneumonia requiring hospitalization: 5-year prospective study. Rev Infect Dis 1989; 11:586-99.
  • 16. Hirata-Davis C.A.I., Stein D.J., Guay D.R.P., et al. A randomized study of ciproloxacin versus ceftriaxone in the treatment of nursing home-acquired lower respiratory tract infections. J Am Geriatr Soc 1991; 39:979-85.
  • 17. Drinka P.J., Gauerke C., Voeks S., et al. Pneumonia in a nursing home. J Gen Intern Med 1994; 9:650-2.
  • 18. Marrie T.J., Blanchard W. A comparison of nursing home-acquired pneumonia patients with patients with community-acquired pneumonia and nursing home patients without pneumonia. J Am Geriatr Soc 1997; 45:50-5.
  • 19. Pick N., McDonald A., Bennett N., et al. Pulmonary aspiration in a long-term care setting: clinical and laboratory observations and an analysis of risk factors. J Am Geriatr Soc 1996; 44:763-8.
  • 20. Mylotte J.M. Nursing home acquired pneumonia. Clin Infect Dis 2002; 35:1205-11.
  • 21. Loeb M. Pneumonia in the elderly. Curr Opin Infect Dis 2004; 17:127-30.
  • 22. Maesaki S., Kohno S., Kog H., et al. An outbreak of Legionnaires’ pneumonia in a nursing home. Intern Med 1992; 31:508-12.
  • 23. Stout J.E., Brennen C., Muder R.R. Legionnaires’ disease in a newly constructed long-term care facility. J Am Geriatr Soc 2000; 48:1589-92.
  • 24. Troy C.J., Peeling R.W., Ellis A.G., et al. Chlamydia pneumoniae as a new source of infectious outbreaks in nursing homes. J Am Med Assoc 1997; 277:1214-8.
  • 25. Narain J., Lofgren J., Warren E., et al. Epidemic tuberculosis in a nursing home: a retrospective cohort study. J Am Geriatr Soc 1985; 33:258-62.
  • 26. Cunha B.A. Nursing home acquired pneumonia. Medicine. 2006. Available from: http://www.emedicine.com/med/topic3230.htm.
  • 27. Counsell S.R., Tan J.S., Dittus R.S. Unsuspected pulmonary tuberculosis in a community teaching hospital. Arch Intern Med 1989; 149:1274-8.
  • 28. El Solh A.A., Pietrantoni C., Bhat A., et al. Indicators of po­ten­tially drug-resistant bacteria in severe nursing home-acquired pneumonia. Clin Infect Dis 2004; 39:474-80.
  • 29. Reichmuth K., Meyer K. Management of communityacquired pneumonia in the elderly. Ann Long Term Care 2003; 11:S19-22.
  • 30. Stein D. Managing pneumonia acquired in nursing homes: special concerns. Geriatrics 1990; 45:39-42, 47.
  • 31. Fein A.M. Pneumonia in the elderly: overview of diagnostic and therapeutic approaches. Clin Infect Dis 1999; 28:726-9.
  • 32. Meehan T.P., Chua-Reyes J.M., Tate J., et al. Process of care performance, patient characteristics, and outcomes in elderly patients hospitalized with community-acquired or nursing home-acquired pneumonia. Chest 2000; 117:1378-85.
  • 33. Metlay J.P., Schulz R., Li Y.H., et al. Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Arch Intern Med 1997; 157:1453-9.
  • 34. Harper C., Newton P. Clinical aspects of pneumonia in the elderly veteran. J Am Geriatr Soc 1989; 37:867-72.
  • 35. Johnson J.C., Jaydevappa R., Baccash P.D., et al. Nonspecific presentation of pneumonia in hospitalized older people: age effect or dementia? J Am Geriatr Soc 2000; 48:1316-20.
  • 36. Harkness G.A., Bentley D.W., Roghmann K.J. Risk factors for nosocomial pneumonia in the elderly. Am J Med 1990; 89:457-63.
  • 37. Mick D.J. Pneumonia in elders. Geriatr Nurs 1997; 18:99-102.
  • 38. Martinez-Moragon E., Garcia Ferrer L., Serra Sanchis B., et al. Community-acquired pneumonia among the elderly: differences between patients living at home and in nursing homes. Arch Bronconeumol 2004; 40:547-52.
  • 39. Hutt E., Kramer A.M. Evidence-based guidelines for management of nursing home-acquired pneumonia. J Fam Pract 2002; 51:709-16.
  • 40. McGeer A., Campbell B., Emori T.G., el al. Definitions of infection for surveillance in long-term care facilities. Am J Infect Control 1991; 19:1-7.
  • 41. Naughton B.J., Mylotte J.M. Treatment guideline for nursing home acquired pneumonia based on community practice. J Am Geriatr Soc 2000; 48:82-8.
  • 42. Mehr D.R., Binder E.F., Kruse R.L., et al. Predicting mortality in nursing home residents with lower respiratory tract infection: The Missouri LRI Study. JAMA 2001; 286:2427-36.
  • 43. Muder R., Aghababian R., Loeb M., et al. Nursing home-acquired pneumonia: an emergency department treatment algorithm. Curr Med Res Opin 2004; 20:1309- 20.
  • 44. Bentley D.W., Bradley S., High K., et al. Practice guideline for evaluation of fever and infection in longterm care facilities. J Am Geriatr Soc 2001; 49:210-22.
  • 45. Nicolle L.E., Bentley D.W., Garibaldi R., et al. Antimicrobial use in long-term care facilities. Infect Control Hosp Epidemiol 2000; 21:537-45.
  • 46. Hutt E., Frederickson E., Kramer A.M. Association between quality of care and survival in nursing home acquired pneumonia. Abstract presented at: American Geriatrics Society 58th Annual Scientific Meeting; May 9-13, 2001; Chicago, IL.
  • 47. Fried T.R., Gillick M.R., Lipsitz L.A. Short-term functional outcomes of long-term care residents with pneumonia treated with and without hospital transfer. J Am Geriatr Soc 1997; 45:302-6.
  • 48. Ноников В.Е. Пневмонии в пожилом и старческом возрасте: диагностика и лечение. Consilium-medicum 2003; 5(12):691-5.
  • 49. Dosa D. Should I hospitalize my resident with nursing home-acquired pneumonia? J Am Med Dir Assoc 2006; 7(3 Suppl):S74-80, 73.
  • 50. Li J., Birkhead G.S., Strogatz D.S., et al. Impact of institution size, staffing patterns, and infection control practices on communicable disease outbreaks in New York state nursing homes. Am J Epidemiol 1996; 143:1042-9.
  • 51. Kutner J.S., Kramer A.M., Mortimore E.F., et al. Hospitalization of nursing home residents: a qualitative study. Ann Long-Term Care 1998; 6:1-10.
  • 52. Loeb M., Bentley D.W. 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; 22:120-4.
  • 53. Mehr D.R., Foxman B., Colombo P. Risk factors for mortality from lower respiratory infections in nursing home patients. J Fam Pract 1992; 34:585-91.
  • 54. Gleason P.P., Meehan T.P., Fine J.M., et al. Associations between initial antimicrobial therapy and medical outcomes for hospitalized elderly patients with pneumonia. Arch Intern Med 1999; 159:2562-72.
  • 55. High K.P. Pneumonia in older adults: new categories and complexity to diagnosis and care. Postgrad Med 2005; 118:18-28.
  • 56. Marrie T.J. Community-acquired pneumonia in the elderly. Clin Infect Dis 2000; 31:1072.
  • 57. Martinez J.A., Horcajada J.P., Almela M., et al. Addition of a macrolide to a beta-lactam-based empirical antibiotic regimen is associated with lower in-hospital mortality for patients with bacteremic pneumococcal pneumonia. Clin Infect Dis 2003; 36:389-95.
  • 58. Baddour L.M., Yu V.L., Klugman K.P., et al. Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia. Am J Respir Crit Care Med 2004; 170:440-4.
  • 59. Scully B.E. Therapy of respiratoty tract infection with quinolone antimicrobial agents. In: Quinolone Antimicrobial Agents, 2nd ed., Ed. Hooper D.C., Wolfson J.S., Washington, 1993; 339-62.
  • 60. Синопальников А.И. Левофлоксацин: ступенчатая терапия внебольничной пневмонии. Русский медицинский журнал 2001; 15:3-10.
  • 61. Meehan T.P., Fine M.J., Krumholz H.M., et al. Quality of care, process, and outcomes in elderly patients with pneumonia. JAMA 1997; 278:2080-4.
  • 62. Short A.E., Zadeikis N., Xiang J.X., et al. A multicenter, randomized, double-blind, retrospective comparison of 5- and 10-day regimens of levofloxacin in a subgroup of patients aged >65 years with community-acquired pneumonia. Clin Ther 2005; 27:1251-9.
  • 63. File T.M. Jr. New insights in the treatment by levofloxacin. Chemotherapy 2004; 50(Suppl 1):22-8.
  • 64. Падейская Е.Н. Фармакокинетика левофлоксацина как основа режима дозирования и оптимизации схем ле­чения. Клиническая фармакокинетика 2005; 2-3:58-71.
  • 65. Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices. MMWR 1997; 46(No. RR-8):1-24.
  • 66. Advisory Committee on Immunization Practices (ACIP) Recommendations: Recommended adult immunization schedule. MMWR 2006; 55(40):Q1-Q4.
  • 67. Prevention and control of influenza recommendations of the Advisory Committee on Immunization Practices (ACIP). CDC, MMWR 2006; 55(RR10):1-42.
  • 68. Potter J., Stott D.J., Roberts M.A., et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997; 175:1-6.
  • 69. Carman W.F., Elder A.G., Wallace L.A., et al. Effects of influenza vaccination of health-care workers on mortality, of elderly people in long-term care: a randomized controlled trial. Lancet 2000; 355:93-7.
  • 70. Yoneyama T, Yoshida M, Ohrui T, et al. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc 2002; 50:4303.
  • 71. Yamaya M., Yanai M., Ohrui T., et al. Interventions to prevent pneumonia among older adults. J Am Geriatr Soc 2001; 49:8590.
Просмотров
0 Аннотация
0 PDF
0 Цитирования
Поделились