Infections and infection control among residents of eight rural Wisconsin nursing homes

During 1984 and 1985, an initial prevalence survey and six consecutive months of comprehensive prospective surveillance were conducted in eight rural Wisconsin nonproprietary nursing homes managed by eight nonprofit hospitals in the same communities. Our purpose was to define the infections in the residents and the infection control programs in the nursing homes. The initial prevalence survey analyzed the records of all 403 residents of the eight nursing homes. The average resident was 83.4 years old and had 3.4 chronic diseases noted on the chart. During this initial survey, 52 (12.9%) of the residents were found to have 56 active infections of all types. During six consecutive months of comprehensive surveillance in the eight nursing homes, 265 episodes of acute infection were found for an overall incidence of 10.7 infections per 100 resident months. Clusters of infection by site, pathogen, or month of onset were quite uncommon throughout the study. Susceptibility testing of organisms recovered from infections failed to reveal any clinically important resistance patterns. Because nursing homes are different in many respects from hospitals, appropriately modified definitions and infection control strategies are required for nursing homes and their residents.