Infections and antimicrobial resistance in long term care facilities: a national prevalence study

Ann Ig. 2013 Mar-Apr;25(2):109-18. doi: 10.7416/ai.2013.1912.

Abstract

Background: A point prevalence survey (PPS) was conducted in Italy in 2010, as part of the first European PPS in Long Term Care Facilities (LTCFs), conducted within the HALT Project.

Methods: The PPS was aimed at estimating the prevalence of infections, antimicrobial resistance, and antibiotic use and to assess the status of infections control programs in this setting.

Results: Ninety two LTCFs, located in 11 different Italian regions, participated to the study: 9391 residents were enrolled, 9285 of whom were eligible according to the study criteria. The prevalence of residents with signs/symptoms of infection was 6.5% (606 residents); 438 residents were on antimicrobial treatment (4.7%) and 526 had signs/symptoms (5.7%) but in 324 residents only (3.5/100 residents) the infection satisfied the modified McGeer criteria and was considered confirmed. The most frequent infection site was the respiratory tract (1.27/100 residents). Mostly of the antibiotics were prescribed for respiratory tract infections (42.8% of the antibiotics) and for urinary tract infections (26.6%). The most frequently prescribed classes were quinolones, followed by penicillin plus beta-lactamase inhibitor and 3rd generation cephalosporins. Few infection had a microbiological confirmation, but among the 143 isolated microorganisms 24% were multidrug resistant.

Conclusions: The burden of infections and antimicrobial resistance in LTCFs is significant and infection control and surveillance program are urgently needed.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Bacteriological Techniques / statistics & numerical data
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Resistance, Bacterial*
  • Drug Resistance, Multiple, Bacterial
  • Drug Utilization / statistics & numerical data
  • Female
  • Health Surveys*
  • Homes for the Aged / organization & administration
  • Homes for the Aged / statistics & numerical data*
  • Humans
  • Infection Control / organization & administration
  • Institutionalization / statistics & numerical data*
  • Italy / epidemiology
  • Long-Term Care* / organization & administration
  • Male
  • Nursing Homes / organization & administration
  • Nursing Homes / statistics & numerical data*
  • Population Surveillance
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Anti-Bacterial Agents