A quarter of nursing home residents are colonized with drug-resistant bacteria. The significant presence of multidrug-resistant gram-negative bacteria (MDR-GNB), such as E. coli, among nursing home residents demonstrates the need for heightened infection control prevention and control measures in nursing homes, according to a meta-analysis published in the American Journal of Infection Control, the official journal of the Association for Professionals in Infection Control and Epidemiology (APIC). Researchers also found that nine of the 12 studies involved identiﬁed speciﬁc factors that are associated with increased MDR-GNB colonization risk, including advanced age, gender, comorbid chronic diseases, history of recurrent hospitalization, increased interaction with healthcare workers, frequent antimicrobial exposure, delayed initiation of effective antibiotic therapy, presence of medical devices, decreased functional status, advanced dementia, nonambulatory status, fecal incontinence, severe sepsis present on admission, and residency in a long-term care facility. "This study underscores the importance of having strong infection prevention programs in all nursing homes and long-term care facilities," said 2017 APIC President Linda Greene, RN, MPS, CIC, FAPIC. "Understanding the dynamics and cause of MDR-GNB transmission is crucial to identifying effective infection control strategies speciﬁc to these settings." Prevention and management of MDR-GNB in nursing homes are complicated and require extensive infection control resources due to challenges common to this setting such as understaffing, fewer resources, insufficient training, and inadequate surveillance. "Identifying which patients are most prone to an increased risk of MDR-GNB will enable infection preventionists to tailor efforts and stem future contaminations," wrote Aliyu, et al. "The results of our study suggest that there is much more to be done with regard to infection prevention within nursing homes, and that increased measures must be taken with elderly patients in regard to MDR-GNB colonization." According to the Centers for Disease Control and Prevention, the percentage of gram-negative bacteria that are resistant to drugs is increasing. MDR-GNB cause serious infections in healthcare settings including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Article: Prevalence of multidrug-resistant gram-negative bacteria among nursing home residents: A systematic review and meta-analysis, Sainfer Aliyu, MPhil, MSEd, MHPM, BSN, RN, Arlene Smaldone, PhD, CPNP, CDE, Elaine Larson, PhD, RN, CIC, FAAN, American Journal of Infection Control, doi: 10.1016/j.ajic.2017.01.022, published online April 2017.
Tau proteins are involved in more than twenty neurodegenerative diseases, including various forms of dementia. These proteins clump together in patients’ brains to form neuronal tangles: protein aggregation that eventually coincides with the death of brain cells. Prof. Patrik Verstreken’s research team (VIB-KU Leuven) has now discovered how tau disrupts the functioning of nerve cells, even before it starts forming tangles. They immediately suggest a way to intervene in this process.
Tau proteins are best known as the proteins that are stacked to form neuronal “tangles” in Alzheimer’s patients’ brains, but they also play a role in many other brain disorders such as Parkinson’s and Huntington’s disease. In healthy circumstances, tau proteins are connected to the cytoskeleton of nerve cells, where they support the cells’ structural stability. In the nerve cells of patients, however, tau is dislodged from the cytoskeleton and ultimately tangles together to form protein accumulations that disrupt the nerve cell’s functioning.
But even before these…