Infection Trends in US Nursing Homes, 2006-2013.
Carolyn T A Herzig, Andrew W Dick, Mark Sorbero and 4 others
PMID 28552333WHAT IT FOUND
UTI and pneumonia were the most common reported infections in US nursing homes.
From 2011 to 2013, UTI, multidrug-resistant infections, and wound infections fell, while viral hepatitis rose; some changes likely reflect new assessment definitions.
Key findings
01In 2013, nursing home residents had an estimated 1.13 to 2.68 million infections.
02UTI was the most common reported infection, followed by pneumonia; 30-day UTI prevalence ranged from 5.6% to 8.1%, and 7-day pneumonia prevalence ranged from 1.4% to 2.5% across all 32 quarters.
03After accounting for MDS 3.0 shifts, UTI, multidrug-resistant infections, and wound infections decreased and viral hepatitis increased; indwelling catheter use declined by 0.041 percentage points per year.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Infections present on admission or occurring before the first routine quarterly assessment were not captured, and infections requiring hospitalization were not readily identifiable, so the reported burden may underestimate true nursing home infections. Prevalence was based on 7-day look-back periods, except UTI with 30 days, so these estimates are not full quarterly infection prevalence. Changes in MDS 3.0 definitions, especially for UTI and active diagnoses, likely affected reported trends, so observed decreases and increases may reflect measurement changes as well as true changes. MDS infection definitions do not match federal long-term care infection surveillance definitions, and facility data collection and reporting may vary. The MDS does not include items for all infection types, such as acute gastroenteritis.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not read the decline in reported UTI prevalence as proof that fewer residents had true infections. The MDS 3.0 definition became more specific, and the study did not test an infection prevention intervention.