Point prevalence survey of healthcare-associated infections and use of antimicrobials in Irish intellectual disability long-term care facilities: 2013

Abstract

Healthcare-associated infections (HCAIs) and use of antimicrobials are prevalent in long-term care facilities (LTCFs), but few data are available on the burden of these issues in intellectual disability (ID) LTCFs. To assess the prevalence of HCAIs and use of antimicrobials in Irish ID-LTCFs to plan future HCAI prevention programmes. A national point prevalence survey was conducted in Irish ID-LTCFs in May 2013 using a European protocol. All Irish ID-LTCFs with full-time residents were invited to participate in this voluntary survey. Data were collected locally and analysed at the national coordinating centre. Twenty-four Irish ID-LTCFs participated, with 1060 residents surveyed, representing 42% of ID-LTCF residents in Ireland. The crude HCAI prevalence rate was 4.3% (median 2.2, range 0-46.7), with respiratory tract infections (1.6%) and skin infections (1.6%) being the most prevalent types. Antimicrobials were prescribed for 10% of eligible residents (median 7.5, range 3.2-13.9), with 49% of all prescriptions indicated for prophylaxis. Prevention of urinary tract infections (38%), respiratory tract infections (36%) and skin infections (27%) were the most common reasons for prophylaxis. There was considerable variation in the prevalence of prescribing for prophylaxis across ID-LTCFs (range 2-29%), with only 17% of facilities having local antimicrobial guidelines in place. There is a considerable burden of HCAIs and use of antimicrobials, particularly for skin and respiratory tract infections, in Irish ID-LTCFs. Further surveillance in this population is needed to help guide preventive strategies for ID-LTCF residents at risk of these infections.