Point prevalence survey of healthcare-associated infections and use of antimicrobials in Irish intellectual disability long-term care facilities: 2013

Abstract

Background: Healthcare-associated infections (HCAIs) and use of antimicrobials are prevalent in long-term care facilities (LTCFs), but few data are available on the burden of these issues in intellectual disability (ID) LTCFs.

Aim: To assess the prevalence of HCAIs and use of antimicrobials in Irish ID-LTCFs to plan future HCAI prevention programmes.

Methods: A national point prevalence survey was conducted in Irish ID-LTCFs in May 2013 using a European protocol. All Irish ID-LTCFs with full-time residents were invited to participate in this voluntary survey. Data were collected locally and analysed at the national coordinating centre.

Results: Twenty-four Irish ID-LTCFs participated, with 1060 residents surveyed, representing 42% of ID-LTCF residents in Ireland. The crude HCAI prevalence rate was 4.3% (median 2.2, range 0-46.7), with respiratory tract infections (1.6%) and skin infections (1.6%) being the most prevalent types. Antimicrobials were prescribed for 10% of eligible residents (median 7.5, range 3.2-13.9), with 49% of all prescriptions indicated for prophylaxis. Prevention of urinary tract infections (38%), respiratory tract infections (36%) and skin infections (27%) were the most common reasons for prophylaxis. There was considerable variation in the prevalence of prescribing for prophylaxis across ID-LTCFs (range 2-29%), with only 17% of facilities having local antimicrobial guidelines in place.

Conclusion: There is a considerable burden of HCAIs and use of antimicrobials, particularly for skin and respiratory tract infections, in Irish ID-LTCFs. Further surveillance in this population is needed to help guide preventive strategies for ID-LTCF residents at risk of these infections.

Keywords: Antimicrobial use; Healthcare-associated infection; Intellectual disability; Long-term care facility.