[Important to reduce the risk of infections in residential facilities]

In view of the fact that Swedish nursing home care represents an integrated form of residential housing and health care and it is not possible to classify infections as either "health-care-associated" or "community-acquired". Thus it is not appropriate to use the same surveillance systems as those used in hospitals. The presence of known risk factors for infection--either related to medical devices or due to underlying illness--could however be monitored. Antibiotic treatment favours selection of resistant bacterial strains and should thus be used with prudence. At December 8th, 2000, we investigated the presence of 20 risk factors and antibiotic treatment among 2,817 residents in nursing homes in Uppsala county. Seventeen out of 20 risk factors were all present in less than 1 per cent of the residents. Pressure ulcers or leg/foot-ulcers occurred among 3.2% each, and 7.6 per cent of the residents had an indwelling urinary catheter. About 6% of the residents were treated with at least one antibiotic. Urinary tract infection was the main reason for treatment. The investigation shows that training of nursing home staff by the infection control team should focus on hand hygiene and routines for wound care and urinary catheter care in order to minimize the risk for infections among residents.