Healthcare-associated infections in European long-term care facilities: how big is the challenge?

Editorials Healthcare-associated infections in European long-term care facilities: how big is the challenge? Citation style for this article: Suetens C. Healthcare-associated infections in European long-term care facilities: how big is the challenge?. At the same time, healthcare systems are striving for cost optimi-sation, which results, among other things, in shorter hospital stays and early discharge. These two factors combined have led to a rapid rise in the demand for nursing homes and other social and healthcare services for the elderly such as long-term care facilities (LTCFs), residential homes and home care. The Organisation for Economic Cooperation and Development (OECD) estimated that across OECD countries (these include 22 countries of the EU and European Economic Area (EEA)), about 12% of the population aged 65 years and older received some form of long-term care service in 2009 , either at home (64.5% of the services) or in institutions (35.5%) [3]. Based on these figures, the European Centre for Disease Prevention and Control (ECDC) estimates the number of residents in LTCFs in the EU at approximately 3.7 million in 2010, a number that will certainly increase in the coming decades. Because of age-related dysfunctions of the immune system and physiological changes, the elderly are more sensitive to infection and therefore predisposed to the most frequent infections occurring in nursing homes: urinary tract infections, pneumonia, skin and soft tissue infections and gastro-intestinal infections, in particular those for which previous antibiotic use is a risk factor, such as Clostridium difficile infection [4]. Healthcare-associated infections in LTCFs are also associated with severe consequences including debili-tation, hospital admission and sometimes death [5]. Because of the ageing population, the frequent transfer of patients from LTCFs to hospitals and back to LTCFs, the increasing prevalence of multidrug-resistant microorganisms such as meticillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and vancomy-cin-resistant Enterococcus spp. (VRE), and the low availability of infection control resources in these facilities [6,7], prevention and control of healthcare-associated infections in European LTCFs is becoming an increasing challenge. The number of patients acquiring a healthcare-associated infection in acute care hospitals in the EU has previously been estimated at 4.1 million each year [6], but there is no similar estimate for LTCFS. Facing the lack of EU-wide data on healthcare-associated infections in LTCFs, ECDC provided funding for the Healthcare Associated infections in Long-Term care facilities (HALT) The project's aims were to support prevention of healthcare-associated-infections and antimicrobial resistance in …