Prevalence of long-term care acquired infections in nursing and residential homes in the Emilia-Romagna region

Background: Hardly any data on the occurrence of infection in Italian nursing homes have been published; yet Italy has the second oldest population in the world. The objective of the study was to assess the frequency of infections in a sample of Italian nursing homes. Materials and Methods: A 1-day prevalence survey was conducted in three local health authorities (LHAs) of the Emilia-Romagna region in Italy, aimed at describing the prevalence of patients with long-term care facility-associated infections and their associated factors among residents of nursing and residential facilities. All nursing homes (NHs) and a stratified random sample of residential homes (RHs) in the three LHAs were included in the study, for a total of 1,926 elderly people in 49 facilities. The following data were recorded: infections, medical condition, activities of daily living (ADL), use of antibiotics. The main outcome of the study was infection prevalence. Results: The prevalence of patients with long-term care facility-associated infection was 8.4/100 residents overall (CI 95% 7.9-9.0), 14.6/100 in NHs and 7.5/100 in RHs (CI 95% 6.8-8.1). The prevalence of infection significantly varied with LHA and facility. It was associated with level of dependency and exposure to invasive procedures, such as urinary catheterization and parenteral procedures. Six percent of residents received a systemic antimicrobial on the day of the study, and in 22% of cases there was no evidence of suspected or diagnosed infections. Conclusion: The prevalence study identified a high prevalence of infected patients in nursing homes in Italy, consistent with observation in other geographic areas.