Two years of infection surveillance in a geriatric long-term care facility

Prospective infection surveillance was carried out for 2 years on two selected units of an 800-bed geriatric long-term care facility. Information was obtained by discussion with attending medical and nursing staff members, chart review, and review of laboratory data. Unit A houses 47 ambulatory Home for the Aged (nursing home) residents (70% female) with a mean age of 89 years. Unit B, for patients requiring chronic hospitalization, houses 32 residents (60% female) with a mean age of 77 years. The infection rates per 1000 patient-days on units A and B were 1.77 and 9.45, respectively. The higher infection rate on unit B was probably due to the presence of a more debilitated patient population. The most common sites of infection on both units were respiratory tract, urinary tract, skin, and soft tissue. The major goals of surveillance in long-term care facilities should be to aid in early detection of outbreaks and to identify preventable endemic infections. Definitions of infection and methods of surveillance that take into account the unique characteristics of elderly subjects residing in long-term care facilities with relatively limited resources need to be developed.