Infections and antimicrobial use in Australian residential aged care facilities: a comparison between local and international prevalence and practices
Mary Smith A C , Sue Atkins B , Leon Worth C , Michael Richards C and Noleen Bennett CA Department of Health, Grampians Region, 21 McLachlan Street, Horsham, Vic. 3400, Australia.
B Department of Health, Grampians Region, 35 Armstrong Street South, Ballarat, Vic. 3350, Australia.
C Victorian Healthcare Associated Infection Surveillance System Co-ordinating Centre, 10 Wreckyn Street, North Melbourne, Vic. 3051, Australia.
D Corresponding author. Email: mary.smith@health.vic.gov.au
Submitted: 29 November 2012 Accepted: 24 April 2013 Published: 14 June 2013
Abstract
Introduction. In July 2011, 29 residential aged care facilities (RACF) located in the Grampians rural region, Victoria, participated in the Grampians healthcare-associated infection (HAI) and antimicrobial use point prevalence study.
Methods. On a single day, trained infection control consultants collected data using two surveys. The RACF survey enabled collection of information (e.g. occupancy levels) about each RACF and its residents. The resident survey was completed for eligible high-level care residents who presented with signs and symptoms of a HAI and/or were prescribed an antimicrobial. A literature review was undertaken so comparisons could be made against similar studies.
Results. The Grampians prevalence of residents presenting with ≥1 HAI (3.8%) was higher than the pooled prevalence (2.3%) for four international studies (P = 0.01). The Grampians prevalence of residents prescribed ≥1 antimicrobial (8.3%) was higher than the pooled prevalence (5.8%) for eight international studies (P = 0.009).
Conclusion. The prevalence of the Grampians residents presenting with ≥1 HAI and residents prescribed ≥1 antimicrobial were both observed to be significantly higher than pooled data from similar international studies.
What is known about this topic? RACF residents are vulnerable to HAI for a variety of reasons (e.g. comorbidities and functional disabilities). Inappropriate antimicrobial use for these HAI may lead to the emergence of antimicrobial resistance, adverse drug reactions and excessive costs. The literature does not extensively detail surveillance programs that measure HAI or antimicrobial use in Australian RACF.
What does this paper add? In a sample of Australian RACF, the Grampians point prevalence study established a baseline prevalence of HAI and antimicrobial use. The rates calculated were shown to be significantly high when compared with similar studies.
What are the implications for practitioners? Quality improvement initiatives that might decrease the prevalence of HAI and antimicrobial use in Australian RACF should be investigated and supported by key stakeholders.
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