Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance.
OBJECTIVE
To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities.


METHODS
Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly.


METHODS
248 geriatric units in 77 hospitals located in northern France.


METHODS
All hospital inpatients on the day of the survey were included.


RESULTS
Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity.


CONCLUSIONS
The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.
Golliot
F
F
Centre inter-régional de Coordination de la Lutte contre les Infections Nosocomiales Paris-Nord, Institut Biomédical des Cordeliers, France.
Astagneau
P
P
Cassou
B
B
Okra
N
N
Rothan-Tondeur
M
M
Brücker
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology*; D016021:Epidemiologic Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006299:Health Services for the Aged; D006306:Health Surveys; D006757:Hospital Units; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012307:Risk Factors