CONJUNCTIVITIS IN A LONG-TERM-CARE FACILITY

OBJECTIVE: To determine the prevalence, incidence, and etiology of con junctivitis in residents of a long-term care facility. DESIGN: Prospec tive surveillance of episodes of conjunctivitis during two 6-month per iods. SETTING: Three-building, 319-bed, multipurpose, long-term care f acility including units for personal care, chronic care, palliative ca re, rehabilitation, respiratory rehabilitation, and chronic ventilator patients. RESULTS: The incidence of conjunctivitis on different units varied from 0.6 to 3.5 per 1,000 patient-days. One building had a sig nificantly higher rate of acute conjunctivitis and, within that facili ty; the most highly impaired patients had significantly more disease. Patients with chronic conjunctivitis generally were admitted with conj unctivitis; institutionally acquired conjunctivitis proceeding to chro nic conjunctivitis seldom was observed except on the chronic significa ntly more likely to have a diagnosis of glaucoma, ectropion, or entrop ion. Potential bacterial pathogens were isolated from 3 (21%) of 14 an d 24 (38%) of 69 acute episodes for which cultures were available in t he two study periods. Staphylococcus aureus was the most frequent path ogen isolated. Empiric therapy was usually with topical sodium sulamyd or gentamicin, with substantial interphysician variability in prescri bing patterns. Symptom duration did not differ for episodes which did or did not receive topical antimicrobials. CONCLUSION: Conjunctivitis is common in this facility and occurs with increased frequency in more highly impaired residents. Most episodes may not be due to bacterial infection. Further study of optimal management approaches to conjuncti vitis is necessary (Infect Control Hosp Epidemiol 1995;16:210-216).