Nosocomial infections in long-term facilities.

We studied the incidence and prevalence of hospital-acquired infections in our intermediate-care units and the Nursing Home Care Unit at the Veterans Administration Medical Center, Johnson City, TN over a 4-year period (1980 through 1983). The global infection rate was 3.86 per 1,000 patient care days. The lower respiratory tract was the most common site of infection, followed by urinary tract infections, skin infections, bacteremia, wound infections, and infections at other sites. The prevalence study conducted by monthly visits over a 1-year period showed similar results. All of our patients were elderly males with multiple underlying diseases and poor performance status. The high incidence of nosocomial infections in chronic-care facilities relates to the poor functional assessment of the patients, which may increase the susceptibility of these patients to develop infections, mainly lower respiratory and cutaneous infections.