Prevalence and determinants associated with healthcare-associated infections in long-term care facilities (HALT) in the Netherlands, May to June 2010

HAIs (healthcare-associated infections) are likely to become an increasing public health problem. Therefore, a point-prevalence study called HALT (Healthcare-associated infections in long-term-care facilities) was set up by the European Centre for Disease Prevention and Control to determine the prevalence, antibiotic use and determinants associated with HAIs. In the Netherlands, 10 nursing homes (in total 1,429 elderly residents) participated in the study between May and June 2010. Risk and protective factors were determined by calculating relative risks (RRs) and performing multilevel Poisson regression. An overall infection prevalence of 2.8% was found and 3.5% of the residents used antibiotics. Residents’ characteristics such as the presence of pressure wounds (RR: 2.58; 95% CI: 1.04–6.39) and other wounds (RR: 5.70; 95% CI: 2.99–10.86) were risk factors for an HAI, whereas being male (RR: 0.43; 95% CI: 0.21–0.91) was protective. Nursing home characteristics, such as the percentage of shared rooms (≥32%) (RR: 0.49; 95% CI: 0.39–0.62) and percentage of incontinent residents (≥63%) (RR: 0.72; 95% CI: 0.61–0.85) were protective determinants in a multivariate analysis. Special attention is therefore needed for female residents and residents with pressure and other wounds for the prevention of HAIs in Dutch nursing homes.