Infections in long-term care: Challenges in an ageing Europe

The demographic shift towards an ageing population, especially in Europe, place a significant burden on healthcare systems and increasing demand for long-term care facility (LTCF) services. These facilities provide support to both older individuals and patients with disabilities. Despite their importance, LTCFs continue to face challenges in infection prevention and control (IPC) contributing to increase the burden of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR).

The aim of this opinion review is to summarize current global and regional IPC guidance applicable to LTCFs and identifies critical gaps that must be addressed to improve residents' safety.

Global and regional organizations including the World Health Organization (WHO), European Centre for Disease Prevention and Control (ECDC), United States Centre for Disease Control and Prevention (CDC), and other professional organizations provides basic IPC recommendations mostly adapted from acute healthcare settings. Despite these valuable resources, major gaps persist, especially within the European context. One of the major gaps is that most of these IPC guidance are adapted from acute care settings without taking into consideration the unique structural and social differences of LTCFs. The inherent heterogeneity of LTCFs within European countries, the scarcity of high-quality studies assessing different IPC interventions across diverse LTCF types, compounded by the limitations in workforce capacity and surveillance gaps further pose critical challenges to effective IPC guidance.

Unified, evidence-based guidelines specifically designed for LTCFs are urgently needed to warrant the safety and equity of service provided to LTCF residents across different countries and sectors. Such a framework must emphasize continuous surveillance, workforce development, and practical, applicable strategies that can be easily incorporated into the unique nature of LTCFs.