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 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.

Infections and use of antibiotics in residents of long-term care facilities in Hungary

2014 ◽  
Vol 155 (23) ◽  
pp. 911-917 ◽  
Author(s):  
Rita Szabó ◽  
Karolina Böröcz
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Soft Tissues ◽  
Good Practice ◽  
Antibiotic Use ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with 11,823 residents participated in the point-prevalence survey in May, 2013. Results: The prevalence of infections was 2.1%. Skin and soft tissues infections were the most frequent (36%), followed by infections of the respiratory (30%) and urinary tract (21%). Antimicrobials were mostly prescribed for urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common antimicrobials (97.5%) belonged to the ATC J01 class of “antibacterials for systemic use”. Conclusions: The results emphasise the need for a national guideline and education for good practice in long-term care facilities. Orv. Hetil., 2014, 155(23), 911–917.

scholarly journals 1462. Derivation of a Prediction Model for Risk of Drug-Resistant Urinary Tract Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S534-S534
Author(s):  
Sabeen Ali ◽  
Kimberly C Claeys
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Long Term Care ◽  
Previous Literature ◽  
Antibiotic Prescribing ◽  
Drug Resistant ◽  
Term Care ◽  
Tract Infections ◽  
Scoring Tool

Abstract Background Urinary tract infections (UTIs) are among the most common indications for antibiotic therapy. As antibiotic resistance continues to grow, it is critical to identify those at higher risk for drug-resistant (DR) UTIs to guide empiric therapy, improve clinical outcomes, and limit costs of care. The aim of this study was to identify risk factors for DR UTI and develop a risk scoring tool which could aid in empiric antibiotic prescribing. Methods Single-center retrospective pilot study of adult patients treated for UTI from August 1, 2015 to August 31, 2016. Patients who had asymptomatic bacteriuria, were pregnant within 4 months of admission, or had improperly collected urine cultures were excluded. DR was defined as phenotypic resistance to at least 1 agent in 3 or more antibiotic classes commonly used to treat UTIs. Risk factors for DR UTI were derived from previously published literature and multivariable logistic regression of individual patient data (IPD). Adjusted odds ratios (aORs) were developed by combining ORs from previous literature and IPD. A scoring tool was derived from weight-proportional integer-adjusted coefficients of the predictive model aORs. Results Risk factors were derived from 9 previously published studies and adapted using IPD (N = 77) and included: long-term care (aOR = 4.31), prior hospitalization (aOR = 1.8), previous antibiotics (aOR = 4.33), advanced age (aOR = 1.12), urinary catheterization (aOR = 2.2), immune suppression (aOR = 1.6), and male sex (aOR = 2.56). Previous DR UTI was forced into the model (OR = 1.1). Baseline incidence of DR UTI was 28.7%. A risk score from 1 to 20 was developed and applied to IPD and demonstrated an area under the receiver operator curve (AUROC) of 0.625 (95% CI 0.484–0.767). Removing sex from the score produced an AUROC of 0.64 (95% CI 0.497–783). A sensitivity analysis applying the score to only urinary isolates that exhibited resistance to third-generation cephalosporins (13.8%) produced similar results. Conclusion Residence in long-term care and previous antibiotics were among the risk factors most closely associated with DR UTI. Considering cumulative risk scores may be useful in predicting DR UTI however the current study was hindered by a large degree of heterogeneity in previous literature. Disclosures All authors: No reported disclosures.

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.

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