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INFECTION RATES IN RESIDENTS OF LONG-TERM CARE FACILITIES.

M. McArthur*, B. Liu, A.E. Simor, J. Allard, E. Adhgassi and A. McGeer. Mount Sinai Hospital, Sunnybrook and Women's College Health Sciences Centre, The University Health Network and the University of Toronto, Toronto, Ontario.

Objective: Published infection rates in long term care facilities (LTCFs) range from 2-7 infections per 1000 resident days. As part of a study to determine the effect of multivitamins on infections we looked at the overall infection rates in residents of LTCFs in south central Ontario.

Methods: Using standardized definitions, infection surveillance was conducted in 21 LTCFs for the elderly. Over an 18-month period prospective surveillance was done by the facility ICP and retrospective chart review by the study nurse. A diagnosis by either the ICP or the study nurse was accepted for all infections except UTI where the study diagnosis was used.

Results: 767 residents were followed for a total of 291,878 resident days. There were 1325 infections diagnosed for an overall infection rate of 4.5/1000 resident days. The infection rate by home ranged from 2.1-6.2/1000 resident days. 568 residents had at least one infection with residents who had infections having a mean of 2.3 infections.

Infection Site
LRI
URI
SKIN
EYE
GI
UTI
BSI
Rate/1000 res. days
1.40
1.33
0.61
0.57
0.41
0.20
0.03
% of infections
30.9
29.20
13.4
12.5
9.10
4.30
0.60


There were 57 infections that met the criteria for a symptomatic UTI and 81 urinary tract episodes diagnosed as UTIs by the facility ICP that did not fit the definition for infection. Another 163 urinary tract episodes that were not called an infection by either the ICP or the study nurse were treated with antibiotics.

Conclusion: The overall rate of infections in these homes is similar to reported rates. 60% of the infections were respiratory tract. This may be due to enhanced respiratory outbreak surveillance. Our low UTI rate is due to the fact that we excluded episode of asymptomatic bacteriuria. Defining and treating asymptomatic bacteriuria as a UTI remains a problem in LTCFs that needs to be addressed.

 
Presented at:

COMMUNITY AND HOSPITAL INFECTION CONTROL ASSOCIATION - CANADA (CHICA) Conference, The Sheraton Centre, Toronto ON, Canada, May 29-31, 2000.



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