Most Common Infections in Nursing Homes and Their Impact on Residents

The Hidden Impact of Common Infections in Nursing Homes

Every day, 1 in 43 nursing home residents contracts an infection—often with devastating consequences. Families place their trust in nursing homes to provide safe, compassionate care, but neglect, poor hygiene, and improper practices can put residents at serious risk.

Seeing a loved one suffer from avoidable infections is heartbreaking, but understanding the risks and taking action can protect their health.

Learn about the most common infections in nursing homes, how they may impact your loved one, and steps you can take to advocate for better care and hold facilities accountable when standards are not met.

1. Staph Infections (Including MRSA)

Staphylococcus aureus, or staph, can cause skin infections, pneumonia, and bloodstream infections. Methicillin-resistant Staphylococcus aureus (MRSA), a type resistant to antibiotics, poses major risks in nursing homes due to close quarters and shared equipment. One study found 2,824 cases in just 626 nursing homes in the U.S., with 82% of facilities having multiple cases.

Negligent practices, like improper use of antibiotics or failure to monitor wound healing, often contribute to staph infections. Consequences include:

  • Skin and blood infections. MRSA can lead to painful skin infections and abscesses and, if not treated properly, progress to severe blood infections.
  • Pneumonia. MRSA is a common cause of hospital-acquired pneumonia, particularly in nursing home residents who are already prone to respiratory issues.
  • Sepsis. If MRSA spreads to the bloodstream, it can cause life-threatening sepsis, a condition that requires immediate medical intervention.

2. Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are one of the most common health issues in nursing homes. They occur when bacteria enter the urinary system, including the bladder, kidneys, or urethra.

Residents face a higher risk because of challenges like limited mobility, dehydration, or needing urinary catheters. One report found the UTI rate in some facilities was over 11%—more than four times the national average. They often cause serious health problems for nursing home residents, such as:

  • Kidney damage. Untreated infections can harm the kidneys and spread to the bloodstream.
  • Sepsis. When a UTI spreads to the bloodstream, it can cause sepsis, a dangerous condition that can quickly become fatal without treatment.
  • Confusion and delirium. UTIs often trigger confusion or delirium in older adults, worsening cognitive issues or causing sudden behavioral changes.

3. Vancomycin-resistant Enterococci (VRE)

Vancomycin-resistant enterococci (VRE) are bacteria that no longer respond to vancomycin, an antibiotic used to treat serious infections. While they often live harmlessly in the intestines, they can spread to the urinary tract, bloodstream, or wounds, causing severe complications.

Alarmingly, VRE has been linked to an estimated 54,500 infections and 5,400 deaths among hospitalized patients in the U.S. When VRE infections happen in nursing homes, residents may suffer from:

  • Serious complications. VRE bloodstream infections can quickly worsen, leading to organ damage and prolonged hospitalization.
  • Difficult recovery. Wound infections from VRE often take longer to heal and may lead to further complications, especially in residents with existing health issues.
  • Heightened vulnerability. Residents with VRE may need prolonged isolation, which can impact their mental well-being and sense of connection to others.

4. Gram-Negative Bacterial Infections

Gram-negative bacteria, like Escherichia coli (E. coli) and Klebsiella, often cause infections in vulnerable residents, particularly those with weakened immune systems. These infections can be caused by rushed hygiene practices or failure to train staff in infection control.

When not properly managed, these infections can cause:

  • Worsening wounds. Infections delay healing and may result in complications, like tissue damage or additional infections.
  • Hospital stays. Severe infections often require hospitalization, disrupting routines and increasing stress.
  • Side effects from treatment. Strong antibiotics can cause nausea, diarrhea, or kidney problems, which are harder for older adults to manage.

5. Norovirus

Norovirus is a highly contagious virus that causes gastrointestinal illness, commonly known as the “stomach flu.” It spreads quickly in nursing homes due to close quarters, shared spaces, and staff moving between residents.

One study reported more than 400,000 cases in long-term care facilities between 2009 and 2018, leading to 6,641 hospitalizations and 729 deaths. The impact of norovirus on elderly residents includes:

  • Severe dehydration. Frequent vomiting and diarrhea can cause dangerous fluid loss, often requiring medical intervention.
  • Malnutrition. Ongoing illness may prevent residents from eating enough or absorbing nutrients, leaving them fatigued and vulnerable to other health problems.
  • Higher risk of death. Norovirus can cause severe dehydration and organ failure, which can be fatal for older adults.

6. Influenza (Flu)

Influenza, or the flu, spreads quickly in nursing homes, putting older adults at serious risk. Close living quarters and shared spaces make it easy for the virus to spread through coughing, sneezing, or touching contaminated surfaces.

Older adults make up between 70% and 85% of seasonal flu deaths and 50 to 70% of flu-related hospitalizations in the U.S. Despite these risks, only 58% of residents in reporting nursing homes had received a flu vaccine. For vulnerable residents, the flu can lead to:

  • Respiratory complications. The flu often leads to pneumonia or worsens conditions like COPD, making breathing more difficult.
  • Frequent hospitalizations. Severe symptoms often send residents to the hospital, increasing stress and weakening their overall health.
  • Higher death rates. Pre-existing conditions and lower immunity leave many older adults unable to recover from flu-related complications.

7. Respiratory Infections

Respiratory infections like pneumonia and bronchitis are common among nursing home residents due to weakened immune systems and existing conditions. Poor hygiene and delayed medical treatment often exacerbate these risks and can leave residents and their families facing:

  • Extended recovery periods. Respiratory infections like pneumonia can linger for 6 to 12 weeks, leaving residents bedridden and requiring additional care from staff.
  • Loss of independence. Severe breathing difficulties may force residents to rely more on staff for basic tasks, increasing their vulnerability.
  • Family concerns. Watching a loved one struggle with illness can be emotionally draining, and long-term complications often require tough decisions about care.

8. Skin Infections

Skin infections, such as cellulitis, pressure ulcers, and fungal infections, are common among nursing home residents. These infections often develop due to limited mobility or unclean living conditions. Older adults with weakened immune systems or existing conditions like diabetes are especially vulnerable.

When not properly addressed, skin infections can lead to:

  • Painful wounds. Infections like cellulitis or untreated pressure ulcers can cause significant discomfort and make movement difficult.
  • Sepsis risk. If bacteria from a skin infection enter the bloodstream, it can lead to life-threatening complications.
  • Increased dependency. Residents with severe infections may lose mobility or require more intensive care, straining resources and reducing their quality of life.

Prevention and Treatment of Common Nursing Home Infections

When you trust a nursing home to care for your loved one, you expect them to provide a safe, healthy environment. Under the Elder Abuse and Dependent Adult Civil Protection Act, they are legally required to protect residents from harm, including avoidable infections.

Unfortunately, some facilities fail to train staff properly, while others may unintentionally overlook critical care. In the worst cases, neglect or abuse can cause injuries that easily become infected. These are the standards of care you should expect to prevent and manage common nursing home infections:

  • Regular handwashing to reduce the spread of bacteria and viruses among staff and residents
  • Prompt cleaning and dressing of wounds to prevent infections from worsening or spreading
  • Routine vaccinations protect residents from preventable illnesses like influenza and pneumonia
  • Isolation of infected residents minimizes the risk of outbreaks in shared spaces
  • Proper maintenance and disinfection of medical equipment reduces exposure to harmful pathogens
  • Early detection and medical treatment, including antibiotics, when needed, prevent complications and improve recovery outcomes

If a nursing home fails to take these steps and a resident suffers harm as a result, the family has the right to pursue compensation from those at fault.

What To Do if Your Loved One Is Harmed Due to Negligent Care

If you suspect your loved one suffered an infection due to negligence in a nursing home, take these steps to protect them and hold the facility accountable:

Step What To Do
Document Evidence Take photos of injuries, keep medical records, and note dates and details. Include witness statements or staff comments if possible.
File a Complaint To prompt an investigation, submit a formal complaint to the state health department, including detailed evidence and timelines.
Consult an Attorney Speak with an attorney to understand your family’s legal rights for a personal injury or wrongful death case to seek justice for your loved one and the harm they endured. 

Protect Your Loved One From Nursing Home Infections

Infections in nursing homes can have devastating consequences, but adequate care and preventative measures can lower your loved one’s risk. Watch for signs of neglect, such as unsanitary conditions, untreated wounds, or recurring illnesses, and take action if these issues go unaddressed.

Nursing homes have a legal duty to provide a safe environment, and when they fail to meet that standard, you have the right to hold them responsible. If you suspect negligence, contact the appropriate authorities and consult an attorney to protect your loved one’s rights and seek justice.