Soil, seed and climate: developing a strategy for prevention and management of infections in UK nursing homes.

Most studies of nursing home (NH) infections come from the USA and very few from the UK. USA studies lead us to anticipate a rate of 7 infections per 1000 patient days with a point prevalence as high as 16% in UK NH residents. Pneumonia, skin and urine infections would be the most frequent, followed by enteric infection and bacteraemia. Colonization with resistant organisms is increasing in UK NH residents (e.g., MRSA in 4-17%). Surveillance studies are needed in UK NHs to report incidence of infection, residents' characteristics, existence of and adherence to above standards and policies. Trials of effectiveness of different infection control programmes and of NH vs hospital management are required. Management of infection may be a useful marker of quality of care in NHs and therefore of interest to health and local authorities.