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480 Comparative Study of Infections Related to Healthcare in Long-Term Care Facilities

Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Regina C. Almeida, PhD , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Adriana C. M. Magalhaes, MSc , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Salete C. Carvalho, RN , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Jeruza R. Roesberg, MD , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Tatiana R. M. Freire, RN , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Tiago S. M. Possas, MD , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Alcy M. S. Pereira, MD , Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
Background: The importance of infection control in hospitals for acute care has been well documented since the 1950s. In recent decades, the increase in life expectancy, the aging population, the higher prevalence of chronic diseases and the incidence of psychiatric disorders, strengthen the need for epidemiological knowledge of infections related to care in institutions that receive such patients.
Objective: To describe and compare the incidence of infections related to care which were identified from January 2008 to August 2009 in nine long-stay institutions of FHEMIG network.
Methods: Prospective epidemiological surveillance was carried out, with trained professionals,  using the diagnostic concepts proposed in a Canadian guidelines (1991). The indicator received a government incentive for performance to the 4 hospitals of the Mental Health Complex (MHC), 4 hospitals of the Rehabilitation and Elderly Care Complex (RECC) and 1 hospital of post-trauma rehabilitation (PTR), that include 452 operational beds and 916 beds for residents for more than a year.

Results: In the studied period occurred 11,356 admissions. Indicators and parameters measured varied according to table 1. There was a reduction in infection rates in 2009 compared to 2008 from 10% in MHC, 19% in RECC and 23% in PTR. Prevalent infections were skin and soft tissue in CRCI (43%) and urinary tract in the HRT (30%). In MHC there was an increase in the proportion of UTI in 2009 (from 11 to 20%) and higher proportion of RTI in 2008 (14%).
  Table 1 – Indicators and Parameters of Infections in Long-Term Care Facilities, FHEMIG, Jan 2008 to Aug 2009

MHC
RECC
PTR
2008
2009
2008
2009
2008
2009
Numbers of Infections
359
205
592
343
77
44
Total pacient-days
177.863
114.874
104.792
74.991
11.100
8.287
Incidence density
2,0
1,8
5,7
4,6
6,9
5,3
Mean ± SD
2,8±1,9
1,4±0,8
9,0±4,2
7,0±2,3
7,1±3,1
4,9±2,2
Median
2,4
1,15
8,3
6,4
7,3
5,4
(min, max)
0 ;18,9
0 ; 4,3
0,4 ; 38,7
3,9 ; 11,4
0 ; 10,7
1,8 ; 8,2
Conclusions: Lower rates suggests the effectiveness of programs of infection control and their importance in these institutions. Changes in prevalence recorded in the MHC should be assessed in specific studies.