Healthcare-associated infection among residents of long-term care facilities: a cohort and nested case–control study

• Published in: The Journal of hospital infection Vol. 65; no. 4; pp. 334 - 340
• Main Authors: Eriksen, H.M, Koch, A.M, Elstrøm, P, Nilsen, R.M, Harthug, S, Aavitsland, P
• Format: Journal Article
• Language: English
• Published: Kent Elsevier Ltd 01-04-2007; Elsevier
• Subjects: Aged, 80 and over; Biological and medical sciences; Case-Control Studies; Confidence Intervals; Female; General aspects; Geriatrics - statistics & numerical data; Healthcare-associated infections; Human infectious diseases. Experimental studies and models; Humans; Incidence; Infection - etiology; Infectious Disease; Infectious diseases; Long-Term Care; Long-term care facilities; Male; Medical sciences; Nephrology. Urinary tract diseases; Norway; Norway - epidemiology; Nursing Homes; Pneumology; Population Surveillance - methods; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Surveillance; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Norway; Europe; Nursing homes; Long-term care facilities; Surveillance; Norway; Healthcare-associated infections; Lung disease; Nosocomial infection; Urinary system disease; Respiratory disease; Chronic disease; Cardiovascular disease; Urinary tract disease; Case control study; Urinary incontinence; Voiding dysfunction; Heart disease; Cohort study; Ulcer; Bladder disease; Skin; Homes for the aged; Pneumopathy; Public health
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2006.11.011

Summary Knowledge of infection control measures in nursing homes is limited. This study aimed to assess the incidence of, and potential risk factors for, healthcare-associated infection in long-term care facilities in Norway. Incidence of healthcare-associated infection was recorded prospectively in six long-term care facilities located in two major cities in Norway between 1 October 2004 and 31 March 2005. For each resident with an infection we aimed for two controls in a nested case–control study to identify potential risk factors. Incidence of infection was 5.2 per 1000 resident-days. Urinary and lower respiratory tract infections were the most common. Patients confined to their beds [odds ratio (OR = 2.7)], who stayed <28 days (OR = 1.5), had chronic heart disease (OR = 1.3), urinary incontinence (OR = 1.5), an indwelling urinary catheter (OR = 2.0) or skin ulcers (OR = 1.8) were shown to have a greater risk for infection. Age, sex and accommodated in a two- versus single-bed room were not significant factors. Incidence of infection in nursing homes in Norway is within the range reported from other countries. This study identified several important risk factors for healthcare-associated infection. There is a need to prevent infection by implementing infection control programmes including surveillance in long-term care facilities.