Surveillance of infection burden in residential aged care facilities
| Autor: | Susan C McLellan, Sneha Parikh, Anton Y. Peleg, Joanne M Culton, David C. M. Kong, Ching Jou Lim, Allen C. Cheng |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Victoria Concordance Inappropriate Prescribing Skin infection Anti-Infective Agents Cost of Illness medicine Prevalence Infection control Homes for the Aged Humans Practice Patterns Physicians' Aged Retrospective Studies Aged 80 and over Cross Infection Infection Control Respiratory tract infections business.industry Incidence (epidemiology) Incidence Retrospective cohort study General Medicine medicine.disease Drug Utilization Specimen collection Population Surveillance Emergency medicine Bronchitis business |
| Zdroj: | The Medical journal of Australia. 196(5) |
| ISSN: | 1326-5377 |
| Popis: | Objectives To explore the burden of illness associated with infectious syndromes and to measure the associated use of antimicrobials in residential aged care facilities (RACFs). Design, setting and subjects Retrospective analysis of data for January 2006 to December 2010 from an infection surveillance system covering residents of four co-located RACFs, with a total of 150 residential care beds, in Melbourne, Victoria. Main outcome measures Number of episodes and incidence of health care-associated infection (HCAI); rate of antimicrobial use; prescribing concordance with McGeer criteria for infection; frequency of clinical specimen collection. Results There were 1114 episodes of an infectious syndrome over 267, 684 occuppied bed-days (OBD), affording an average HCAI rate of 4.16 episodes/1000 OBD annually over 5 years (95% CI, 3.92-4.41). The mean rate of antimicrobial use was 7.07 courses/1000 OBD (range, 6.71-7.84). Around 40% of antimicrobial prescribing was for episodes that did not fulfil the McGeer criteria for clinical infection; this included about half of suspected urinary tract and upper respiratory tract infections (URTI), and about one-third of suspected lower respiratory tract and skin infections. Antimicrobials were routinely prescribed for URTI and bronchitis. Of all episodes treated with antimicrobials, 36% had documentation that a clinical specimen was obtained. Conclusions The HCAI rate remained relatively stable over time. Routine surveillance and feedback of infection rates to the facilities did not result in a noticeable decrease of infection burden over time. It is of immediate concern that antimicrobials were being prescribed for a large proportion of suspected infections that did not meet criteria for clinical infection. Opportunities exist to further improve the use of antimicrobials in the RACF setting. |
| Databáze: | OpenAIRE |
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