Clinical and Epidemiological Study

Infection

, Volume 41, Issue 1, pp 1-8

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Infection control: point prevalence study versus incidence study in Polish long-term care facilities in 2009–2010 in the Małopolska Region

  • J. Wójkowska-MachAffiliated withChair of Microbiology, Jagiellonian University Medical College Email author 
  • , B. GryglewskaAffiliated withDepartment of Internal Medicine and Gerontology, Jagiellonian University Medical College
  • , J. CzekajAffiliated withNursing Home
  • , P. AdamskiAffiliated withInstitute of Nature Conservation, Polish Academy of Sciences
  • , T. GrodzickiAffiliated withDepartment of Internal Medicine and Gerontology, Jagiellonian University Medical College
  • , P. B. HeczkoAffiliated withChair of Microbiology, Jagiellonian University Medical College

Abstract

Objective

The objective of this study was to evaluate the epidemiology of infection in Polish long-term care facilities (LTCFs) and to analyse the capabilities and legitimacy of implementing continuous targeted surveillance.

Methods

The study investigated the relationship between the presence of infection and health status, tested using a point prevalence study (PPS) and incidence study. A 1-day PPS was carried out in October 2009, with prospective continuous surveillance between December 2009 and November 2010. Infections were defined according to McGeer’s criteria.

Results

The surveillance encompassed 193 people. The prevalence was 14.0 % in residential homes (RHs) and 18.7 % in the nursing home (NH). Various types of infections (in the PPS) were observed significantly more frequently in patients with asthma, wounds, atherosclerosis of lower extremities, tracheotomy tubes and conditions in patients hospitalised in intensive care units (ICUs) up to 1 year before the PPS day. The incidence rate was 2.7/1,000 patient days (pds).

Conclusions

The factors determined to be important for the risk of infection (in the continuous study) include the general status of patients, expressed using Barthel, abbreviated mental and Katz scales, as well as limited physical activity, stool incontinence and urinary catheterisation. In the PPS study, only a slight relationship was shown between the general status of residents and the risk of infection. None of the general status scales used clinically were shown to be helpful in estimating that risk, similarly to the five-point physical activity scale. Prospective continuous surveillance shows a possibility of limiting the range of infection control in the LTCFs within targeted surveillance in a population of patients that requires intensive nursing procedures. As a marker, one could point to the low score in the Barthel or Katz scales or low physical activity/bedridden persons.

Keywords

Long-term care facilities Point prevalence study Incidence study Target surveillance