Abstract
HAIs (healthcare-associated infections) are likely to become an increasing public health problem. Therefore, a point-prevalence study called HALT (Healthcare-associated infections in long-term-care facilities) was set up by the European Centre for Disease Prevention and Control to determine the prevalence, antibiotic use and determinants associated with HAIs. In the Netherlands, 10 nursing homes (in total 1,429 elderly residents) participated in the study between May and June 2010. Risk and protective factors were determined by calculating relative risks (RRs) and performing multilevel Poisson regression. An overall infection prevalence of 2.8% was found and 3.5% of the residents used antibiotics. Residents' characteristics such as the presence of pressure wounds (RR: 2.58; 95% CI:1.04-6.39) and other wounds (RR: 5.70; 95% CI: 2.99-10.86) were risk factors for an HAI, whereas being male (RR: 0.43; 95% CI: 0.21-0.91) was protective. Nursing home characteristics, such as the percentage of shared rooms ( ≥ 2%) (RR: 0.49; 95% CI: 0.39-0.62) and percentage of incontinent residents (≥ 3%) (RR: 0.72; 95% CI: 0.61-0.85) were protective determinants in a multivariate analysis. Special attention is therefore needed for female residents and residents with pressure and other wounds for the prevention of HAIs in Dutch nursing homes.
Highlights
The European Centre for Disease Prevention and Control (ECDC) defines healthcare-associated infections (HAIs) as infections occurring after exposure to healthcare, often, but not always, as a consequence of this exposure [1]
Antibiotics were used by 50 residents
The percentage of antibiotic use turned out to be higher than the prevalence of HAIs
Summary
The European Centre for Disease Prevention and Control (ECDC) defines healthcare-associated infections (HAIs) as infections occurring after exposure to healthcare, often, but not always, as a consequence of this exposure [1]. HAIs are a major challenge: in Europe, they are a frequent source of morbidity and mortality and the leading reason for residents of long-term-care facilities (LTCFs) to be hospitalised [2,3,4]. HAIs may have an impact on the quality of life of the residents in LTCFs [4,6], but this hypothesis needs more research. People are especially prone to HAIs because their immune response may be diminished due to malnutrition, polypharmacy and the presence of multiple chronic diseases [4,7]. The most common HAIs reported are respiratory, urinary, gastrointestinal, skin and tissue infections [2]
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