Healthcare-associated infection in Irish long-term care facilities: results from the First National Prevalence Study.
BACKGROUND
Prevalence of healthcare-associated infection (HCAI) and antimicrobial use in Irish long-term care facilities (LTCFs) has never been studied.


OBJECTIVE
To collect baseline data on HCAI prevalence and antibiotic use in Irish LTCFs to inform national LTCF policy and plan future HCAI prevention programmes.


METHODS
A prevalence study of HCAI and antibiotic use was undertaken in Irish LTCFs. Participation was voluntary. Data on HCAI risk factors, signs and symptoms of infection and antimicrobial use were collected prospectively on a single day in each institution.


RESULTS
Sixty-nine Irish LTCFs participated and 4170 eligible residents were surveyed; 472 (11.3%) had signs/symptoms of infection (266, 6.4%) and/or were on antibiotics (426, 10.2%). A third of residents (1430, 34.3%) were aged ≥85 years and more than half disorientated (2110, 50.6%) with impaired mobility (2101, 50.4%). HCAI prevalence was 3.7% (range: 0-22.2%). The most common HCAI was urinary tract infection (UTI) (62 residents, 40% of HCAI). Presence of a urinary catheter was associated with UTI (P < 0.0000001). Antibiotics were prescribed for treatment (262 residents, 57.8%) and prophylaxis (182 residents, 40.2%) of infection. The most common indication for prophylaxis was UTI prevention (35.8% of total prescriptions). Fourteen (10.2%) residents on UTI prophylaxis had a urinary catheter. The most common indications for therapy included respiratory tract infections (35.1%), UTI (32.1%) and skin infection (21.8%).


CONCLUSIONS
This study highlights the frequency of prophylactic antimicrobial prescribing and provides an important baseline to inform future preventive strategies.
Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland. mcotter@mater.ie
M
M
Cotter
S
S
Donlon
F
F
Roche
H
H
Byrne
F
F
Fitzpatrick
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D012871:Skin Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents