Just under 4% of elderly residents in Irish long-term care facilities had a confirmed healthcare-associated infection, such as MRSA according to a new study. Niall Hunter,Irish Health, reports:

The study highlighted the wide variation in the level of medical care among long-stay facilities.

Of the 4,170 residents studied in 69 nursing homes and other long-stay centres, 3.6% had a confirmed healthcare-associated infection (HCAI) when physician diagnosis of infection was included as a criterion in all categories of infection.

Of residents surveyed, 11.3% had either signs or symptoms of infection.

The most common confirmed HCAI reported was urinary tract infection, followed by respiratory and skin infections.

The study, carried out by the Health Protection Surveillance Centre as part of an EU-wide survey, also found that 12 of the long-stay facilities examined had no infection prevention and control practitioner in place.

The research found that guidelines for appropriate antibiotic use were only available in 28% of long-term care facilities. The spread of HCAIs is associated with overuse of antibiotics, to which some bacteria can become resistant.

A total of 10.2% of residents surveyed were on antibiotics. The report found antibiotic use in the centres surveyed was considerably higher than the European average of 5.9%.

Antibiotics were prescribed for treatment of infection in 58% of cases and for prevention of infection in 42% of cases.

The study authors felt the level of preventive antibiotic prescribing was of concern.

The report said there was a wide variation in the delivery of medical care in the facilities studied.

The number of GPs providing medical care in the centres varied widely within each region and the number of attending GPs did not correlate with the size of long-stay facility.

The report said there was no coordination of medical activities in over 50% of the facilities surveyed.

The authors said facilities with a coordinating doctor were more likely to have antibiotic prescribing guidelines to help guide prescribers and minimise resistance to antibiotics.

The study found that the majority of participating long-stay care centres had a trained infection prevention and control practitioner.

It said the availability of written protocols for areas such as hand hygiene and management of catheters was impressive.

However, it said it was difficult to imply that this was truly representative of infection control activities and resources, and it said there was a need for a comprehensive national survey on infection control activities and resources in long-term facilities to help future prevention strategies.

The researchers found that of the total number of patients on antibiotics for treatment of an infection, 35 had  culture test results for bacteria available - three were found to have MRSA and seven had C.Diff organism present.

The study concluded that while the HCAI prevalence in the centres surveyed was lower than previously reported from other European countries, a wide range was observed between individual facilities.

This, the authors said, may reflect differences between the different long-stay centres - for example, different centres may have different dependency levels among patients.

The study found there was a low rate of pressure sores and urinary catheter use, despite a high proportion of incontinent and/or immobile residents, and this reflected high quality nursing and medical care in the facilloties  surveyed.

The long-stay care centres surveyed were nearly all public facilities.

View the full study here

Source: www.irishhealth.com