Background The European Centre for Disease Prevention and Control promoted the HALT project (Healthcare-Associated Infections in Long-Term Care Facilities) to support the control of healthcare-associated infections (HAI) and antimicrobial use in European Long-Term Care Facilities (LTCF).
Purpose To study the prevalence of HAI, antibiotic use and available infection control resources in Asti (Italy). A point prevalence survey (PPS) was performed in May–June 2013 by the multidisciplinary team of Local Health Unit of Asti.
Materials and methods An institutional questionnaire collected denominator data regarding risk factors and aggregated data on residents’ characteristics (care load). A resident questionnaire was filled in for each resident with an antibiotic treatment and/or signs and symptoms of infection on the day of the survey.
Results A total of 7 LTCF participated in the PPS: 452 eligible residents (25% male, 56% >85 years). Incontinence, disorientation and impaired mobility were reported in 67%, 64% and 62% of the cases, respectively. On the PPS day, 5.9% of the residents presented antibiotic treatment and/or signs and symptoms of infection (prevalence in Italy 5.9%; in Europe 4.1%). The most frequently reported infection site concerned the respiratory tract (98%) followed by the skin (1%), the gastrointestinal tract (1%). Antimicrobials were prescribed in 2% of the residents: 82% treatment; 18% prophylaxis. Third-generation cephalosporins (45%) were most commonly prescribed, followed by combinations of penicillins including beta-lactamase inhibitors (18%), macrolides (9%), imidazole derivatives (9%). The most frequently reported tasks were: development of an infection prevention policy and antibiotic policy; non-available training of nursing staff and care protocols.
Conclusions The development of an antibiotics policy is an important element for having good antimicrobial stewardship; local LTCF teams need additional and specific training in order to improve assessment of infection and antibiotic use in this setting.
No conflict of interest.
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