scholarly journals Healthcare-Associated Infections in the Long-Term Care Setting: An Analysis of Reports From Pennsylvania

2020 ◽  
Author(s):  
Shawn Kepner ◽  
Amy Harper ◽  
Rebecca Jones ◽  
Caitlyn Allen ◽  
Regina Hoffman ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Homes ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Long Term Care ◽  
Reporting Rate ◽  
Term Care ◽  
Tract Infections ◽  
Healthcare Associated

The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States. In addition to over 3.6 million Acute Care records, PA-PSRS has collected more than 330,000 Long-Term Care (LTC) healthcare-associated in¬fection reports since 2009. A total of 28,310 infections were reported in 2019, representing a 9% decrease from the prior year. The Northwest region of the state had the highest infection reporting rate, with 1.25 reports per 1,000 resident days. There was a 20% reduction in both the number and reporting rate of respiratory tract infections from 2018 to 2019; however, respiratory tract infections remained the most frequently reported infection type overall. Cellulitis, soft tissue, or wound infection was the most frequently reported infection subtype in 2019, followed by pneumonia and symptomatic urinary tract infection. With this information, nursing homes and interested parties can determine which trends or characteristics of the data are relevant for reduction in infections in nursing homes. Overall, this analysis demonstrates areas in which continued education and infection prevention measures can be applied to further enhance the safety for residents in long-term care facilities.

scholarly journals 2020 Healthcare-Associated Infections in the Long-Term Care Setting: An Analysis of Reports From Pennsylvania

2021 ◽  
pp. 22-33
Author(s):  
Shawn Kepner ◽  
Amy Harper ◽  
Rebecca Jones
Keyword(s):  
Patient Safety ◽  
Urinary Tract ◽  
Soft Tissue ◽  
Infection Rate ◽  
Respiratory Tract Infections ◽  
Long Term Care ◽  
Term Care ◽  
Tract Infections ◽  
Healthcare Associated

The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States. In addition to over 3.9 million acute care records, PA-PSRS has collected more than 357,000 long-term care (LTC) healthcare-associated infection reports since 2009. A total of 26,331 infections were reported in 2020, representing a 7.0% decrease from the prior year. The Northeast region of the state had the highest overall infection rate, with 1.29 reports per 1,000 resident days, and the Southeast region had the largest increase in infection rate from the prior year (increased from 0.87 to 1.02). There was a 10.2% increase in respiratory tract infections from 2019 to 2020; however, the other four main infection types decreased (gastrointestinal by 44.6%, device-related bloodstream by 17.0%, skin and soft tissue by 16.5%, and urinary tract by 1.8%). Additionally, of the four infection subtypes that comprise the respiratory tract infections category, all increased from 2019 to 2020 except for pneumonia. The most frequently reported infection subtype in 2020 was cellulitis, soft tissue, or wound infection, although it had the second largest decrease from 2019. The infection rate for catheter-associated urinary tract infections (CAUTI) had the largest increase from 2019 to 2020, and the rate for norovirus had the largest decrease from 2019 to 2020. Infection rates also differed across the various nursing unit types. The seasonal peak for respiratory infections in 2020 occurred in the second quarter, with the exception of influenza, which peaked in the first quarter. Overall, this analysis demonstrates areas in which continued education and infection prevention measures can be applied to further enhance the safety for residents in long-term care facilities.

scholarly journals Patterns of Antimicrobial Use for Respiratory Tract Infections in Older Residents of Long-Term Care Facilities

2011 ◽  
Vol 59 (6) ◽  
pp. 1093-1098 ◽  
Author(s):  
Paschalis Vergidis ◽  
Davidson H. Hamer ◽  
Simin N. Meydani ◽  
Gerard E. Dallal ◽  
Tamar F. Barlam
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Long Term Care ◽  
Antimicrobial Use ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

scholarly journals Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Strong Evidence ◽  
Disease Transmission ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Meta Analyses ◽  
Tract Infections

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.

Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013–2017

2020 ◽  
Vol 42 (1) ◽  
pp. 31-36
Author(s):  
Taniece R. Eure ◽  
Nimalie D. Stone ◽  
Elisabeth A. Mungai ◽  
Jeneita M. Bell ◽  
Nicola D. Thompson
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections

AbstractObjective:Antibiotic resistance (AR) is a growing and highly prevalent problem in nursing homes. We describe selected AR phenotypes from pathogens causing urinary tract infections (UTIs) reported by nursing homes to the National Healthcare Safety Network (NHSN).Design:Pathogens and antibiotic susceptibility testing results for UTI events in nursing homes between January 2013 and December 2017 were analyzed. The pathogen distribution and pooled mean proportion of isolates that tested resistant to select antibiotic agents are reported.Setting and Participants:US nursing homes voluntarily participating in the Long-Term Care Facility component of the NHSN.Results:Overall, 243 nursing homes reported 1 or more UTIs: 121 (50%) were nonprofit facilities, median bed size was 91 (range: 9–801), and average occupancy was 87%. In total, 6,157 pathogens were reported for 5,485 UTI events. Moreover, 9 pathogens accounted for 90% of all reported UTIs; the 3 most frequently identified were Escherichia coli (41%), Proteus species (14%), and Klebsiella pneumoniae/oxytoca (13%). Among E. coli, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively). Although Staphylococcus aureus and Enterococcus faecium represented <5% of pathogens reported, they had the highest rates of resistance (67% methicillin resistant and 60% vancomycin resistant, respectively). Multidrug resistance was most common in Pseudomonas aeruginosa (11%). For the resistant phenotypes we assessed, 36% of all UTIs reported were associated with a resistant pathogen.Conclusions:This is the first summary of AR among common pathogens causing UTIs reported to NHSN by nursing homes. Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.

scholarly journals Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria

2012 ◽  
Vol 33 (10) ◽  
pp. 965-977 ◽  
Author(s):  
Nimalie D. Stone ◽  
Muhammad S. Ashraf ◽  
Jennifer Calder ◽  
Christopher J. Crnich ◽  
Kent Crossley ◽  
...  
Keyword(s):  
Respiratory Tract Infections ◽  
Long Term Care ◽  
Review Of The Literature ◽  
Consensus Panel ◽  
Term Care ◽  
Infection Surveillance ◽  
Norovirus Gastroenteritis ◽  
Care Facilities ◽  
Tract Infections

Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.Infect Control Hosp Epidemiol 2012;33(10):965-977

scholarly journals Prospective Surveillance of Healthcare-Associated Infections in Residents in Four Long-Term Care Facilities in Graz, Austria

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 544
Author(s):  
Elisabeth König ◽  
Mara Medwed ◽  
Christian Pux ◽  
Michael Uhlmann ◽  
Walter Schippinger ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Long Term Care ◽  
Health Centre ◽  
Healthcare Associated Infections ◽  
Prospective Surveillance ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections ◽  
Healthcare Associated

Healthcare-associated infections (HCAI) are a common cause for residents’ mortality and morbidity associated with a significant socio-economic burden. Data on HCAIs in Austrian long-term care facilities are scare. Therefore, we evaluated the incidence rate of HCAIs per 1000 resident days in four LTC facilities in Graz, Austria, characterized the spectrum of HCAIs and the use of antimicrobial substances. We conducted a prospective surveillance study from 1 January to 31 December 2018 in four LTCFs of the Geriatric Health Centre of the City of Graz (total of 388 beds). Nursing staff collected data on HCAIs once a week using an electronic reporting system. During the 12-month surveillance period, 252 infections of 165 residents were recorded. The overall incidence rate of HCAIs was 2.1 per 1000 resident days. Urinary tract infections were the most commonly recorded HCAIs (49%, 124/252, 1.03 per 1000 resident days), followed by skin and soft tissue infections and respiratory tract infections. Beta-lactams (ATC class J01C) were prescribed most frequently (63/212), followed by fluoroquinolones (J01M; 54/212). In conclusion, the overall incidence rate for HCAIs was relatively low at 2.1 per 1000 resident days. Our real-life data can serve as a basis for future antimicrobial stewardship and infection prevention interventions.

scholarly journals Pilot Point-Prevalence Survey for Healthcare-Associated Infections in Long-Term Care Hospitals, South Korea, 2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s350-s350
Author(s):  
Jongrim Choi ◽  
Ji Young Lee ◽  
Jae Sim Jeong ◽  
Sung Eun Lee ◽  
Jong Hwa Choi ◽  
...  
Keyword(s):  
Infection Control ◽  
South Korea ◽  
Prevalence Rate ◽  
Long Term Care ◽  
Point Prevalence ◽  
Healthcare Associated Infections ◽  
Term Care ◽  
Tract Infections ◽  
Healthcare Associated

Background: Recently, healthcare-associated infections (HAIs) in long-term care hospitals (LTCHs) have markedly increased, but no infection control policy has been established in South Korea. We investigated the current HAI surveillance system and executed a point-prevalence pilot study in LTCHs. Methods: HAIs were defined by newly established surveillance manual based on McGeer criteria revised in 2012. Three LTCHs in Seoul and Gyeonggi province were voluntarily recruited, and data were collected from up to 50 patients who were hospitalized on August 1. The medical records from September to November 2018 were retrospectively reviewed by a charge nurse for infection control per each hospitals after 1 day of training specific for LTCH surveillance. All data were reviewed by a senior researcher visiting onsite. Results: The participating hospitals had 272.33 ± 111.01 beds. Only 1 hospital had an onsite microbiological laboratory. In total, 156 patients were enrolled and 5 HAIs were detected, for a prevalence rate of 3.2%. The average patient age was 79.04 ± 9.92 years. The HAIs included 2 urinary tract infections, skin and soft-tissue infection, low respiratory infection, and conjunctivitis. Conclusions: This is the first survey of HAI in LTCHs in South Korea. The 3.2% prevalence rate is lower than those from previous reports from the European Union or the United States. This study supports the development of a national HAI surveillance and infection control system in LTCHs, although implementation may be limited due to the lack of laboratory support and infection control infrastructure in Korea.Funding: NoneDisclosures: None

scholarly journals Antimicrobial use in European long-term care facilities: results from the third point prevalence survey of healthcare-associated infections and antimicrobial use, 2016 to 2017

2018 ◽  
Vol 23 (46) ◽  
Author(s):  
Enrico Ricchizzi ◽  
Katrien Latour ◽  
Tommi Kärki ◽  
Rossella Buttazzi ◽  
Béatrice Jans ◽  
...  
Keyword(s):  
Long Term Care ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Term Care ◽  
The Third ◽  
Care Facilities ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Eu

Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016–17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8–5.1) of LTCF residents in the EU/EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs.

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