Noleen Bennett1, Nabeel Imam2, Rodney James3, Caroline Chen3, Ann Bull2, Karin Thursky3, Kirsty Buising3, Leon Worth2. 1. National Centre for Antimicrobial Stewardship, Melbourne, VIC, Australia; Victorian Healthcare Associated Infection Surveillance System Co-ordinating Centre, Melbourne, VIC, Australia. Electronic address: Noleen.Bennett@mh.org.au. 2. Victorian Healthcare Associated Infection Surveillance System Co-ordinating Centre, Melbourne, VIC, Australia. 3. National Centre for Antimicrobial Stewardship, Melbourne, VIC, Australia.
Abstract
BACKGROUND: Infections in aged care residents are associated with poor outcomes, and inappropriate antimicrobial prescribing contributes to adverse events, such as the emergence of antimicrobial resistance. The objective of this study was to identify resident- and facility-level factors associated with infection and antimicrobial prescribing in Australian aged care residents. METHODS: Using data captured by a national point-prevalence survey (the Aged Care National Antimicrobial Prescribing Survey), risk and protective factors were determined by multivariate Poisson regression. RESULTS: In 2017, 292 facilities were surveyed. Infection prevalence was 2.9% (95% confidence interval [CI], 2.6%-3.2%), and antimicrobial use prevalence was 8.9% (95% CI, 8.4%-9.4%). Resident-level factors associated with infection prevalence included urinary catheterization and hospital admission within the last 30 days; facility-level factors included state and multipurpose service provision. Resident-level factors associated with antimicrobial prescribing included infection signs and symptoms; facility-level factors included state, nonmetropolitan locality, and not-for-profit status. Availability of guidelines for urinary tract infection (UTI) management was associated with reduced antimicrobial prescribing. CONCLUSIONS: Looking ahead, reports should be peer grouped by significant facility-level factors. Priority should be given to implementing UTI management guidelines and prevention of infection in residents with indwelling urinary catheters. Enhanced monitoring and prevention strategies are required for residents recently admitted to hospital.
BACKGROUND:Infections in aged care residents are associated with poor outcomes, and inappropriate antimicrobial prescribing contributes to adverse events, such as the emergence of antimicrobial resistance. The objective of this study was to identify resident- and facility-level factors associated with infection and antimicrobial prescribing in Australian aged care residents. METHODS: Using data captured by a national point-prevalence survey (the Aged Care National Antimicrobial Prescribing Survey), risk and protective factors were determined by multivariate Poisson regression. RESULTS: In 2017, 292 facilities were surveyed. Infection prevalence was 2.9% (95% confidence interval [CI], 2.6%-3.2%), and antimicrobial use prevalence was 8.9% (95% CI, 8.4%-9.4%). Resident-level factors associated with infection prevalence included urinary catheterization and hospital admission within the last 30 days; facility-level factors included state and multipurpose service provision. Resident-level factors associated with antimicrobial prescribing included infection signs and symptoms; facility-level factors included state, nonmetropolitan locality, and not-for-profit status. Availability of guidelines for urinary tract infection (UTI) management was associated with reduced antimicrobial prescribing. CONCLUSIONS: Looking ahead, reports should be peer grouped by significant facility-level factors. Priority should be given to implementing UTI management guidelines and prevention of infection in residents with indwelling urinary catheters. Enhanced monitoring and prevention strategies are required for residents recently admitted to hospital.
Authors: N J Bennett; N Imam; R J Ingram; R S James; K L Buising; A L Bull; C S Chen; K A Thursky; L J Worth Journal: Epidemiol Infect Date: 2019-01 Impact factor: 2.451