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Nosocomial Infections in Geriatric Long-Term-Care and Rehabilitation Facilities: Exploration in the Development of a Risk Index for Epidemiological Surveillance

Published online by Cambridge University Press:  02 January 2015

Franck Golliot ,
Pascal Astagneau ,
Bernard Cassou ,
Nicole Okra ,
Monique Rothan-Tondeur  and
Gilles Brücker
Franck Golliot
Affiliation:
Centre inter-régional de Coordination de la Lutte contre les Infections Nosocomiales Paris-Nord, Institut Biomédical des Cordeliers, Paris
Pascal Astagneau*
Affiliation:
Centre inter-régional de Coordination de la Lutte contre les Infections Nosocomiales Paris-Nord, Institut Biomédical des Cordeliers, Paris
Bernard Cassou
Affiliation:
Consultation de gérontologie, RFR 12 INSERM, hôpital Sainte Périne, Paris
Nicole Okra
Affiliation:
Service de gérontologie, hôpital Vaugirard, Paris
Monique Rothan-Tondeur
Affiliation:
Unité d'hygiène hospitalière et d'épidémiologie, hôpital Charles Foix, Ivry, France
Gilles Brücker
Affiliation:
Centre inter-régional de Coordination de la Lutte contre les Infections Nosocomiales Paris-Nord, Institut Biomédical des Cordeliers, Paris
*
Pascal Astagneau, CCLIN Paris-Nord, Institut Biomédical des Cordeliers, 15-21 rue Ecole de Médecine, 75006 Paris, France
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Abstract

Objective:

To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities.

Design:

Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly.

Setting:

248 geriatric units in 77 hospitals located in northern France.

Participants:

All hospital inpatients on the day of the survey were included.

Results:

Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity.

Conclusion:

The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 12 , December 2001 , pp. 746 - 753
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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