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

Abstract

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.

Validation of the prevalence to incidence conversion method for healthcare associated infections in long-term care facilities

“…However, the lack of a significant difference could be due to the small number of events seen in the longitudinal study, which is in line with previous reports. An Austrian study with a similar design and which applied definitions based on the ECDC HALT project found an HAI incidence of 2.1 episodes per 1000 patient-days in 2018 (COVID-19 cases were not included) [ 10 ].…”

“…However, longitudinal studies of HAI incidence are relatively more resource-intensive compared to PPS, which is particularly true for the LTCF setting. In fact, very few HAI incidence studies conducted in LTCFs have been published to date [ 9 , 10 ].…”

Implementation of an antimicrobial stewardship program for urinary tract infections in long-term care facilities: a cluster-controlled intervention study

“…This difference could reflect a different prescription culture between physicians serving at LTCFs in the intervention group and control group. In 2018, systematic surveillance of health-care associated infections was initiated in the LTCFs of the Geriatric Health Centers Graz (intervention group ) [16]. Antimicrobial prescriptions were also recorded.…”

Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain

“…It is also necessary to record the number of episodes of skin and soft tissue infections over time and evidence of the periodic review of written protocols for prevention and treatment of pressure ulcers. fections in nursing homes and its incidence is estimated to be around 1 episode per 1000 stays in studies in Austria [163] and Germany [164]. ITU criteria must be strict [165] avoiding overinterpretation of simple positive urine cultures without clearly attributable symptomatology.…”

“…Urinary Tract Infection (UTI) accounts for 49% of all in-fections in nursing homes and its incidence is estimated to be around 1 episode per 1000 stays in studies in Austria [ 163 ] and Germany [ 164 ]. ITU criteria must be strict [ 165 ] avoiding over-interpretation of simple positive urine cultures without clearly attributable symptomatology.…”