Chlamydia pneumoniae as a new source of infectious outbreaks in nursing homes
C. J. Troy, R. W. Peeling, A. G. Ellis, J. C. Hockin, D. A. Bennett, M. R. Murphy and J. S. Spika
Ontario Ministry of Health, Toronto, Canada.
OBJECTIVE: To determine the extent and severity of illness and mode of
transmission of Chlamydia pneumoniae infection in 3 nursing home outbreaks.
DESIGN AND SETTING: Retrospective cohort study in 3 nursing homes in
Ontario from September to November 1994. SUBJECTS: A total of 549 residents
and 65 staff members. MAIN OUTCOME MEASURES: Morbidity and mortality were
determined by a review of disease surveillance forms, residents' charts,
and a self-administered questionnaire to staff. Single and paired serum
samples for C pneumoniae serological testing and nasopharyngeal swabs for C
pneumoniae culture were collected, and direct fluorescent antibody assays
were performed to confirm C pneumoniae infection. RESULTS: The attack rates
for confirmed and suspected cases combined were 68%, 46%, and 44% among
residents in nursing homes A, B, and C, respectively, and 34% among nursing
home C staff. A total of 16 cases of pneumonia confirmed by chest x-ray and
6 deaths were identified. The spectrum of illness among nursing home C
residents included a new cough in 58 (100%), fever in 37 (64%), sore throat
in 14 (24%), and hoarseness in 8 (14%). Staff members at nursing home C
were more likely to report hoarseness (P<.001) and sore throat
(P<.001). Residents who smoked had onset of illness earlier than
nonsmokers (P=.007), which perhaps is related to airborne transmission in a
designated smoking room. CONCLUSIONS: Chlamydia pneumoniae caused serious
morbidity and mortality among residents and morbidity among staff; C
pneumoniae is an important cause of respiratory disease outbreaks in
nursing homes, and diagnostic tests must be readily available for early
recognition of C pneumoniae infections.
Outbreak of Chlamydophila pneumoniae infection in long-term care facilities and an affiliated hospital
Miyashita et al.
J Med Microbiol 2005;54:1243-1247.
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Chlamydia species as a cause of community-acquired pneumonia in Canada
Marrie et al.
Eur Respir J 2003;21:779-784.
ABSTRACT
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BTS Guidelines for the Management of Community Acquired Pneumonia in Adults
Thorax 2001;56:iv1-64.
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A prospective comparison of nursing home acquired pneumonia with community acquired pneumonia
Lim and Macfarlane
Eur Respir J 2001;18:362-368.
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Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines
Lim et al.
Thorax 2001;56:296-301.
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Gemifloxacin: survival of the fittest
Mandell
J Antimicrob Chemother 2000;46:33-37.
ABSTRACT
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Associations Between Initial Antimicrobial Therapy and Medical Outcomes for Hospitalized Elderly Patients With Pneumonia
Gleason et al.
Arch Intern Med 1999;159:2562-2572.
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Risk Factors for Pneumonia and Other Lower Respiratory Tract Infections in Elderly Residents of Long-term Care Facilities
Loeb et al.
Arch Intern Med 1999;159:2058-2064.
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Molecular diagnostics of infectious diseases
Tang et al.
Clin. Chem. 1997;43:2021-2038.
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*CHLAMYDIA PNEUMONIAE* EMERGES AS AN IMPORTANT CAUSE OF INFECTION IN NURSING HOMES
JWatch General 1997;1997:6-6.
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