Nosocomial infections and antibiotic utilization in long-term care facilities : traditional versus protective care settings

Abstract

Retrospective surveillance for nosocomial infection and antibiotic utilization was conducted at three multi-skilled long-term care facilities in St. John's, Newfoundland. The average incidence of facility acquired infection, based on the units under study, was 9.1 infections per 1000 resident days. No significant differences in infection rates were found between the protective care units and the traditional ward units. The most common source of infection was respiratory tract infections (36.6%); eye, ear, nose and mouth infections (21.0%); and skin infections (19.2%). The four most common pathogens documented in culture results were Escherichia coli (31.3%), Pseudomonas aeuroginosa (17.6%), Enterococcus faecalis (9.8%), and Klebsiella pneumoniae (9.8%). The most common treatments prescribed for infection were Sodium Salamyd (16.4%), Amoxil (12.7%), and Septra (10.3%). Among all residents surveyed, over the two year period, 70.1% received at least one course of antibiotics. In addition, antibiotic resistance was noted in 49.3% of all pathogens identified in the study. This study concludes that both nosocomial infections and antibiotic resistant pathogens are increasing in the long-term care environment.