1538. Nationwide Prevalence of Long Term Care Healthcare-Associated Infections in U.S. Department of Veterans Affairs Community Living Centers
Session: Poster Abstract Session: Infections in Non-Acute Healthcare Settings
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Clifton poster 9-13 small size (3).pdf (1.3 MB)
  • Background:

    Veterans Health Administration (VHA) has 133 Community Living Centers (CLCs, formally Nursing Home Care Units) and is the largest single provider of nursing home care in the United States.   VHA has conducted a one-day point prevalence survey (PPS) for CLC-associated infections (CLCAIs) during alternating years since 2005 which have been used to structure staff education plans, examine work flow patterns, and provide direction to enhance infection prevention and control measures.   The most recent PPS was conducted in 2012.

    Methods: One-day, web-based PPS was conducted in VHA CLCs in December 2012.  All residents in a CLC bed at the time of the PPS were evaluated for presence of CLCAI(s).  Modified CDC HAI definitions were used and were unchanged from those used for prior PPSs.  Additional data included in the 2012 survey were causative organism(s) for each CLCAI.

    Results:

    All CLCs participated in the PPS. 

     

     2012

    2009

    2007

    2005

     

     

     

     

     

    #Residents

    9679

    10402

    10939

    11475

    # CLCAIs (# of residents with CLCAIs)

    403 (391)

    453 (433)

    613 (575)

    640 (591)

    % residents with CLCAIs

    4.0%

    4.2%

     5.3%

    5.2%

     

     

     

     

     

    Symptomatic UTI

     23.1%*

     30.5%

     29.2%

    28.3%

    Asymptomatic bacteriuria  

     15.1%

     10.2%

     10.4%

     12.34%

    Pneumonia

     

     13.6%

    9.1%

     8.0%

    9.4%

    Skin 

     

     7.4%

    13.5%

     12.9

     9.2%

    Soft Tissue

     

    5.9%

     7.1%

    5.4%

     5.8%

    Osteomyelitis 

     

    5.9%

     5.5%

     3.9%

     4.7%

    *%of all CLCAIs

    Overall decrease in CLCAI rates from 2012 to 2005 was significant (p<0.0001).   A total of 2603 residents had one or more invasive devices; 214 (8.2%) had at least one CLCAI. Prevalence of CLCAIs in residents with an invasive device was 3.3 times the prevalence in those without (p<0.0001).  Leading causative organisms reported for urinary tract infections were E.coli and Proteus spp., lab confirmed bloodstream infections were Staph aureus and MRSA, skin and soft tissue infections were Staph aureus and MRSA and for gastrointestinal tract infections the exclusive organism reported was C. difficile.

    Conclusion: A significant decrease in CLCAIs of 29% may be associated with the continued promotion of device use surveillance and educational programs in VHA CLCs.  The CLC PPSs have provided valuable information on types of CLCAIs, association with presence of invasive devices and from the most recent PPS, CLCAI causative organisms.

    Marla Clifton, RN, MSN, CIC1, Linda Danko, RN, MSN1, Loretta Simbartl, MS1, Christa Hojlo, PhD, RN, NHA2, Lisa Minor, MSSL, RN3, Ona Montgomery, RN, BSN, MSHA, CIC4, Stephen Kralovic, MD, MPH1,5 and Gary Roselle, MD1,6, (1)National Infectious Diseases Service, Department of Veterans Affairs Central Office, Cincinnati, OH, (2)Geriatrics and Extended Care Services, Department of Veterans Affairs, Washington, DC, (3)Geriatric and Extended Care Operations, Department of Veterans Affairs, Washington, DC, (4)VA Medical Center, Amarillo, TX, (5)University of Cincinnati College of Medicine, Internal Medicine, Div of Infectious Diseases, Cincinnati, OH, (6)University of Cincinnati College of Medicine, Internal Medicine, Cincinnati, OH

    Disclosures:

    M. Clifton, None

    L. Danko, None

    L. Simbartl, None

    C. Hojlo, None

    L. Minor, None

    O. Montgomery, None

    S. Kralovic, None

    G. Roselle, None

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