Infections Affect Over Half of EU Long-Term Care Residents

Medscape

23-06-2025

TOPLINE:
In a 12-month longitudinal analysis of long-term care facility residents across European countries, 57% experienced at least one healthcare-associated infection (HAI), with respiratory tract and urinary tract infections being the most common and leading to significant hospitalisations and deaths.
METHODOLOGY:
Researchers conducted a longitudinal cohort study across nine European countries to examine the incidence of HAIs and their associated hospitalisations and mortality in residents of long-term care facilities.
They analysed 3029 residents (mean age, 80.9 years; 68% women) who stayed in their facilities, including general nursing homes, residential homes, and mixed facilities, throughout the 12-month study period.
Data were collected via standardised questionnaires covering facility characteristics, resident demographics, and details about HAIs; infections acquired within the facility or during temporary discharge were included.
The primary outcome was the incidence of HAIs; secondary outcomes included HAI-related hospitalisations (occurring between the onset and resolution) and HAI-associated deaths.
TAKEAWAY:
Overall, 57% of the residents experienced at least one HAI during follow-up, with an incidence rate of 1.8 (95% CI, 0.9-3.3) per 1000 resident days.
Respiratory tract infections were the most common HAIs (28.9%; 95% CI, 27.3-30.5), followed by urinary tract infections (18.7%; 95% CI, 17.2-20.3) and COVID-19 (17.6%; 95% CI, 16.5-18.8).
The incidence of HAI-related hospitalisations was 0.09 (95% CI, 0.05-0.21) per 1000 resident days; the highest incidence was observed for respiratory tract infections, followed by urinary tract infections and COVID-19.
Overall, 4.5% of HAIs were fatal, and respiratory tract infections were the most common cause, accounting for 2.3% of deaths.
IN PRACTICE:
"Nevertheless, these data shed important light on a highly relevant topic within a health-care setting that is often neglected," the authors of a commentary wrote.
"There is a need for ongoing surveillance of infections, work to validate surveillance definitions, and more epidemiological data (eg, pathogen-specific burden, contribution of outbreak vs sporadic infections, and added burden of antimicrobial resistance)," they added.
SOURCE:
This study was led by Enrico Ricchizzi, PhD, Settore Innovazione nei Servizi Sanitari e Sociali, Regione Emilia-Romagna, Bologna, Italy. It was published online on June 16, 2025, in The Lancet Infectious Diseases.
LIMITATIONS:
This study was limited by variability in implementation of the survey across participating facilities and the biased selection of long-term care facilities. The diverse types of facilities included introduced heterogeneity. Moreover, this study did not assess the effect of infection prevention measures or available local resources at each facility.
DISCLOSURES:
This study was supported by the European Centre for Disease Prevention and Control. The authors declared having no competing interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.