Nosocomial infections in a long-term care facility

In order to learn the types and prevalence of infection, incidence data of nosocomial infections were collected for 2 months in a 400-bed long-term care facility of the Veterans Administration. The mean age of infected patients was 70 years; 623 days was the average duration of stay. Using acute care standards (Communicable Disease Center criteria) for definitions, an 18% infection rate was found; urinary tract infections were predominant. The principal pathogens were the opportunistic organisms instead of the usual Escherichia coli. No significant difference in infection rate was found between the two main patient care levels—intermediate and nursing home care. Questions are raised regarding the validity of applying acute care standards to the long-term care setting. Further large-scale longitudinal studies are needed to determine rates of infection and to develop definitions of infection in the chronically ill