Abstract
BackgroundBelgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys). We present the main findings of the three national PPSs conducted in NHs participating in at least one of these surveys, and in a cohort that participated in all three consecutive surveys.MethodsAll NHs were invited to voluntarily participate and conduct the survey on one single day in May-September 2010 (HALT-1), in April-May 2013 (HALT-2) or in September-November 2016 (HALT-3). Data were collected at institutional, ward and resident level. A detailed questionnaire had to be completed for all eligible (i.e. living full time in the facility since at least 24 h, present at 8:00 am and willing to participate) residents receiving at least one systemic antimicrobial agent and/or presenting at least one active HAI on the PPS day. The onset of signs/symptoms had to occur more than 48 h after the resident was (re-)admitted to the NH.ResultsA total of 107, 87 and 158 NHs conducted the HALT-1, HALT-2 and HALT-3 survey, respectively. The median prevalence of residents with antimicrobial agent(s) increased from 4.3% (95% confidence interval (CI): 3.5-4.8%) in HALT-1 to 4.7% (95% CI: 3.5-6.5%) in HALT-2 and 5.0% (95% CI: 4.2-5.9%) in HALT-3. The median prevalence of residents with HAI(s) varied from 1.8% (95% CI: 1.4-2.7%) in HALT-1 to 3.2% (95% CI: 2.2-4.2%) in HALT-2 and 2.7% (95% CI: 2.1-3.4%) in HALT-3. Our post-hoc analysis on the cohort (n = 25 NHs) found similar trends. In all three surveys, respiratory tract infections were most frequently reported, followed by skin/wound infections in HALT-1 and urinary tract infections in HALT-2 and HALT-3. Antimicrobials were most commonly prescribed for the therapeutic treatment of an infection: 66.4% in HALT-1, 60.9% in HALT-2 and 64.1% in HALT-3. Uroprophylaxis accounted for 28.7%, 35.6% and 28.4% of all prescriptions, respectively.ConclusionsNone withstanding the limitations peculiar to the study design, the PPSs enabled us to assess the occurrence of and to increase awareness for HAIs and rational antimicrobial use in NHs at both local and national level.
Highlights
Belgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys)
Since 2009, Belgium monitors the burden of healthcare-associated infections (HAIs; i.e. infections acquired during a stay in a healthcare facility) and antimicrobial use in NHs by participating in the European point prevalence surveys (PPSs) of HAIs and antimicrobial use in long-term care facility (LTCF)
The current paper presents the main findings of the PPSs of HAIs and antimicrobial use in terms of prevalence and characteristics of the reported HAIs and antimicrobial prescriptions and available resources for infection prevention and control (IPC) and antimicrobial stewardship and this in (a) NHs participating in at least one of the surveys, and (b) a cohort of NHs that participated in all three consecutive surveys
Summary
Belgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys). We present the main findings of the three national PPSs conducted in NHs participating in at least one of these surveys, and in a cohort that participated in all three consecutive surveys. Under pressure of an ageing population, the growing burden of chronic diseases and the trend towards reduced length of stay in hospitals, more specialised care is being provided in these healthcare institutions that include among others nursing homes (NHs), LTCFs for mentally or physically disabled persons, psychiatric facilities and rehabilitation centres [1, 2]. HALT-2 (2013) was organised in 1 181 LTCFs across 17 EU/EEA countries and HALT-3 (2016) took place in 3 052 LTCFs across 24 EU/EEA countries [8,9,10,11]
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