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Abstract: Background: To our knowledge, there are few indices that can assess oral health in the elderly. Those that are currently used are subjective and test the impact of oral health on quality of life. It appears to be relevant to create an easy and reproducible index, based on an oral health clinical exam that can be correlated with infectious disease risk in the elderly. Objectives: This article aims to explain the methodology used to create an oral health index to assess infectious disease risk in elderly patients more than 65 years old. Design: Cluster randomized trial. Setting: Long-term care and rehabilitation facilities. Participants: All patients who were included were 65 years old or older and were present in participant wards at the beginning of the study or were admitted during the study period. Measurements: The assessment index was developed with the assistance of two dentists, after conducting a literature review. This was an index composed of eight criteria, which included most oral health problems associated with infections in the elderly. A score of 1 was given if a single criterion was observed. The final score ranged from 0 to 8 (0 for a healthy oral health index and 8 for a bad index). Results: The oral health index was used in 2513 patients. This index grew significantly with age (P =0.002) and malnutrition (P =0.004). The pneumonia incidence rate was significantly correlated with the oral health index (P =0.002). Conclusion: This index is easy to use, with few items, and it takes into account most infectious disease risk factors. It would be interesting to integrate this score into a routine admission check-up process in the elderly for the purpose of preventing infectious diseases. [Copyright &y& Elsevier]

Summary: In France, although there are 445,000 beds in nursing homes (NHs) for elderly people, no studies on the burden of infections in NHs have been published. We sought to estimate the prevalence of infection among the residents and to assess the extent to which infections were associated with the residents’ risk factors. We performed a nationwide, multicentre, cross-sectional, clustered period prevalence survey over five one-month periods. Cases of infection were classified as definite or, in the absence of laboratory confirmation, as probable. A total of 44,869 residents in 578 volunteer facilities were enrolled in the survey. The overall prevalence rate of infections was 11.23% [95% confidence interval (CI): 10.50–11.97] and differed significantly (P <0.001) across survey periods (the time of the year the survey was carried out). The rate of definite cases was 4.60% (95% CI: 4.04–5.54) and the rate of probable cases was 6.63% (95% CI: 5.77–7.98). Respiratory tract infections were the most frequent and accounted for 41% of all infections. Infections were significantly associated with age, length of stay, full disability, urinary device, bedsores and the survey period. Only prevention programmes may reduce the impact of infections on this frail population. [ABSTRACT FROM AUTHOR]

Summary: A nationwide survey was performed using a two-round web-based Delphi procedure to develop a set of consensus guidelines for preventing infections among residents in nursing homes (NHs). The research group was led by an investigative group of six specialists. Research analysts conducted a literature search and review of practice guidelines, systematic reviews and articles or abstracts published in English and French on the topic of infection prevention. The literature search was examined by 23 specialists (who compiled a preliminary list of 301 recommendations). Using a Delphi survey online instrument, 81 experts from all relevant medical specialties in the fields of infection prevention and control and geriatrics rated their agreement with each of the recommendations using a nine-point scale (1=strongly disagree, 9=strongly agree). During the second round, 79 participants received anonymous feedback from the first round and assessed a narrowed list of 130 recommendations. Recommendations were retained and classified according to the overall median score and ratings percentages by stakeholders. A total of 79 raters rated ≥10% of items, and 264 recommendations were retained and rated as follows: 240 items reached consensus, 24 items reached near consensus, 37 items were discarded and one recommendation was deleted. Many infections, though not all, can be prevented in the frail elderly. Thus, these guidelines should be adopted by each healthcare professional and facility to implement routine infection control procedures. [ABSTRACT FROM AUTHOR]