{"id":29109,"date":"2025-10-18T04:19:00","date_gmt":"2025-10-17T20:19:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29109"},"modified":"2025-10-18T07:33:57","modified_gmt":"2025-10-17T23:33:57","slug":"lancet-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a9%e4%b8%aa%e6%ac%a7%e6%b4%b2%e5%9b%bd%e5%ae%b6%e9%95%bf%e6%9c%9f%e7%85%a7%e6%8a%a4%e6%9c%ba%e6%9e%84%e4%b8%ad%e5%8c%bb%e7%96%97%e6%9c%ba","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29109","title":{"rendered":"[Lancet Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a9\u4e2a\u6b27\u6d32\u56fd\u5bb6\u957f\u671f\u7167\u62a4\u673a\u6784\u4e2d\u533b\u7597\u673a\u6784\u76f8\u5173\u611f\u67d3\u7684\u53d1\u751f\u7387"},"content":{"rendered":"\n

Articles<\/p>\n\n\n\n

Incidence of health-care-associated infections in long-term care facilities in nine European countries: a 12-month, prospective, longitudinal cohort study<\/h1>\n\n\n\n

Enrico\u00a0Ricchizzi,\u00a0Elena\u00a0Sasdelli,\u00a0Anna Caterina\u00a0Leucci, et al<\/h3>\n\n\n\n

Lancet Infect Dis Available online 16 June 2025<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1016\/S1473-3099(25)00217-8<\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

The number of older people in need of long-term care is increasing, and health-care-associated infections (HAIs) are a major cause of morbidity and mortality for residents of long-term care facilities (LTCFs). This study, organised by the European Centre for Disease Prevention and Control (ECDC), provided data on the incidence of HAIs and related adverse outcomes<\/a> in LTCFs in European countries, supplementing the available estimates from repeated point prevalence surveys conducted by the ECDC.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

In this longitudinal, prospective cohort study<\/a>, we analysed all HAIs collected in a convenience sample of residents from 65 LTCFs (including general nursing homes, residential homes, and mixed facilities) in nine EU or European Economic Area (EEA) countries (Belgium, Finland, France, Italy, Lithuania, Luxembourg, the Netherlands, Poland, and Spain) over 12 months. Eligible residents were those expected to stay in the LTCF for at least the entire study period. Data were collected with three questionnaires: an institutional questionnaire, a residents' questionnaire, and an HAI questionnaire. HAIs were defined according to standard ECDC criteria. The primary outcome was HAI incidence. Incidence measures, estimated using generalised estimating equation models to account for sample heterogeneity, were percentages of each type of HAI, numbers of HAIs per 100 LTCF residents (ratio), and numbers of HAIs per 1000 resident-days (incidence rate).<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

HAIs were analysed in 3029 residents of LTCFs between Jan 1\u2013May 4, 2022, and Jan 1\u2013May 12, 2023. The mean age of study participants was 80\u00b79 years (SD 14\u00b76), including 960 (31\u00b77%) men and 2069 (68\u00b73%) women. 3763 HAIs were recorded, with at least one HAI identified in 1717 (57%) of 3029 residents. There were 124\u00b72 HAIs (95% CI 118\u00b76\u2013129\u00b79) per 100 residents and 1\u00b78 HAIs (0\u00b79\u20133\u00b73) per 1000 resident-days. 160 (4\u00b73% [95% CI 3\u00b79\u20135\u00b74]) HAIs led to hospitalisation, and 154 (4\u00b75% [2\u00b75\u20134\u00b78]) were associated with death.\u00a0Respiratory tract infections<\/a>\u00a0(RTIs) were the most frequent type of infection (n=1080, 28\u00b79% [95% CI 27\u00b73\u201330\u00b75]), including pneumonia (n=279, 7\u00b73% [6\u00b74\u20138\u00b73]) and other\u00a0lower RTIs<\/a>\u00a0(n=394, 10\u00b77% [9\u00b76\u201311\u00b78]), followed by\u00a0urinary tract infections<\/a>\u00a0(UTIs; n=743, 18\u00b77% [17\u00b72\u201320\u00b73]). RTIs showed the highest incidence of mortality (n=85, 2\u00b73% [95% CI 1\u00b78\u20132\u00b78] of all HAIs). Severe cases of COVID-19 (n=72, 1\u00b79% [95% CI 1\u00b75\u20132\u00b74] of all HAIs) were less frequent than mild or moderate cases (n=615, 16\u00b70% [14\u00b79\u201317\u00b71] of all HAIs).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
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Table 1. Clinical and demographic characteristics of the study population<\/p>\n\n\n\n

Empty Cell<\/td>Empty Cell<\/td>Belgium<\/strong><\/th>Finland<\/strong><\/th>France<\/strong><\/th>Italy<\/strong><\/th>Lithuania<\/strong><\/th>Luxembourg<\/strong><\/th>Netherlands<\/strong><\/th>Poland<\/strong><\/th>Spain<\/strong><\/th>Total<\/strong><\/th><\/tr><\/thead>
LTCFs<\/td>4<\/td>15<\/td>10<\/td>24<\/td>5<\/td>2<\/td>3<\/td>1<\/td>1<\/td>65<\/td><\/tr>
LTCF residents<\/td>260<\/td>344<\/td>702<\/td>395<\/td>368<\/td>153<\/td>275<\/td>269<\/td>263<\/td>3029<\/td><\/tr>
Age, years<\/td>81\u00b72 (11\u00b70)<\/td>84\u00b79 (7\u00b74)<\/td>87\u00b71 (8\u00b77)<\/td>85\u00b70 (10\u00b70)<\/td>61\u00b73 (14\u00b78)<\/td>59\u00b73 (22\u00b76)<\/td>83\u00b73 (10\u00b70)<\/td>84\u00b71 (10\u00b72)<\/td>87\u00b75 (8\u00b75)<\/td>80\u00b79 (14\u00b76)<\/td><\/tr>
Sex<\/td><\/tr>
<\/td>Female<\/td>174 (67%)<\/td>235 (68%)<\/td>516 (74%)<\/td>278 (70%)<\/td>188 (51%)<\/td>73 (48%)<\/td>179 (65%)<\/td>210 (78%)<\/td>216 (82%)<\/td>2069 (68%)<\/td><\/tr>
<\/td>Male<\/td>86 (33%)<\/td>109 (32%)<\/td>186 (26%)<\/td>117 (30%)<\/td>180 (49%)<\/td>80 (52%)<\/td>96 (35%)<\/td>59 (22%)<\/td>47 (18%)<\/td>960 (32%)<\/td><\/tr>
Disorientation<\/td><\/tr>
<\/td>Mild<\/td>52 (20%)<\/td>71 (21%)<\/td>102 (15%)<\/td>105 (27%)<\/td>41 (11%)<\/td>28 (18%)<\/td>53 (19%)<\/td>49 (18%)<\/td>41 (16%)<\/td>542 (18%)<\/td><\/tr>
<\/td>Moderate<\/td>49 (19%)<\/td>111 (32%)<\/td>143 (20%)<\/td>65 (16%)<\/td>67 (18%)<\/td>19 (12%)<\/td>55 (20%)<\/td>80 (30%)<\/td>51 (19%)<\/td>640 (21%)<\/td><\/tr>
<\/td>Severe<\/td>45 (17%)<\/td>135 (39%)<\/td>345 (49%)<\/td>77 (19%)<\/td>57 (15%)<\/td>13 (8%)<\/td>50 (18%)<\/td>101 (38%)<\/td>156 (59%)<\/td>979 (32%)<\/td><\/tr>
<\/td>Missing data<\/td>0<\/td>6 (2%)<\/td>2 (<1%)<\/td>1 (<1%)<\/td>0<\/td>1 (<1%)<\/td>6 (2%)<\/td>4 (1%)<\/td>0<\/td>20 (<1%)<\/td><\/tr>
Mobility<\/td><\/tr>
<\/td>Ambulant<\/td>178 (68%)<\/td>166 (48%)<\/td>397 (57%)<\/td>131 (33%)<\/td>312 (85%)<\/td>118 (77%)<\/td>139 (51%)<\/td>27 (10%)<\/td>163 (62%)<\/td>1631 (54%)<\/td><\/tr>
<\/td>Wheelchair<\/td>75 (29%)<\/td>93 (27%)<\/td>201 (29%)<\/td>250 (63%)<\/td>34 (9%)<\/td>35 (23%)<\/td>124 (45%)<\/td>117 (43%)<\/td>85 (32%)<\/td>1014 (33%)<\/td><\/tr>
<\/td>Bedridden<\/td>7 (2\u00b77%)<\/td>85 (25%)<\/td>102 (15%)<\/td>14 (4%)<\/td>22 (6%)<\/td>0<\/td>9 (3%)<\/td>117 (43%)<\/td>15 (6%)<\/td>371 (12%)<\/td><\/tr>
<\/td>Missing data<\/td>0<\/td>0<\/td>2 (<1%)<\/td>0<\/td>0<\/td>0<\/td>3 (1%)<\/td>8 (3%)<\/td>0<\/td>13 (<1%)<\/td><\/tr>
Incontinence<\/td>168 (64%)<\/td>283 (82%)<\/td>517 (74%)<\/td>279 (71%)<\/td>127 (35%)<\/td>53 (35%)<\/td>144 (52%)<\/td>247 (92%)<\/td>207 (79%)<\/td>2025 (67%)<\/td><\/tr>
<\/td>Missing<\/td>0<\/td>0<\/td>5 (<1%)<\/td>0<\/td>0<\/td>0<\/td>22 (8%)<\/td>10 (4%)<\/td>0<\/td>37 (1%)<\/td><\/tr>
Urinary catheter<\/td>10 (4%)<\/td>22 (6\u00b74)<\/td>11 (2%)<\/td>24 (6%)<\/td>3 (<1%)<\/td>9 (6%)<\/td>35 (13%)<\/td>39 (14%)<\/td>4 (2%)<\/td>153 (5%)<\/td><\/tr>
<\/td>Missing data<\/td>0<\/td>0<\/td>6 (<1%))<\/td>0<\/td>0<\/td>0<\/td>6 (2%)<\/td>27 (10%)<\/td>0<\/td>39 (1%)<\/td><\/tr>
Vascular catheter<\/td>1 (<1%)<\/td>1 (<1%)<\/td>2 (<1%)<\/td>7 (2%)<\/td>0<\/td>0<\/td>1 (<1%)<\/td>18 (7%)<\/td>2 (<1%)<\/td>32 (1%)<\/td><\/tr>
<\/td>Missing data<\/td>0<\/td>0<\/td>6 (<1%)<\/td>0<\/td>0<\/td>0<\/td>7 (3%)<\/td>32 (12%)<\/td>0<\/td>45 (1%)<\/td><\/tr>
Charlson Comorbidity Index<\/td>2\u00b78 (2\u00b74)<\/td>2\u00b75 (2\u00b73)<\/td>3\u00b75 (2\u00b78)<\/td>2\u00b79 (2\u00b72)<\/td>3\u00b71 (3\u00b71)<\/td>1\u00b73 (2\u00b70)<\/td>1\u00b72 (1\u00b74)<\/td>3\u00b74 (2\u00b75)<\/td>2\u00b78 (3\u00b70)<\/td>2\u00b79 (2\u00b77)<\/td><\/tr><\/tbody><\/table>
Data are n, n (%), or mean (SD). Percentages refer to the sample of each country. LTCF=long-term care facility.<\/figcaption><\/figure>\n\n\n\n

Table 2. Ratios of hospitalisations per 100 residents at 7 days and 30 days after HAI onset, by HAI type<\/p>\n\n\n\n

Empty Cell<\/td>7-day hospitalisations<\/strong><\/th>30-day hospitalisations<\/strong><\/th><\/tr>
Empty Cell<\/td>n<\/th>Crude ratio<\/th>Estimated ratio (95% CI)<\/th>n<\/th>Crude ratio<\/th>Estimated ratio (95% CI)<\/th><\/tr><\/thead>
RTIs<\/td>158<\/td>5\u00b72<\/td>4\u00b74 (3\u00b79\u20135\u00b75)<\/td>202<\/td>6\u00b77<\/td>5\u00b71 (4\u00b73\u20135\u00b77)<\/td><\/tr>
UTIs<\/td>110<\/td>3\u00b76<\/td>2\u00b76 (2\u00b71\u20133\u00b77)<\/td>133<\/td>4\u00b74<\/td>2\u00b79 (2\u00b73\u20133\u00b76)<\/td><\/tr>
Skin and soft-tissue infections<\/td>72<\/td>2\u00b71<\/td>1\u00b76 (1\u00b72\u20132\u00b72)<\/td>86<\/td>2\u00b78<\/td>1\u00b79 (1\u00b74\u20132\u00b74)<\/td><\/tr>
COVID-19<\/td>57<\/td>1\u00b79<\/td>1\u00b76 (1\u00b72\u20132\u00b70)<\/td>72<\/td>2\u00b74<\/td>2\u00b70 (1\u00b76\u20132\u00b75)<\/td><\/tr>
Gastrointestinal infections<\/td>35<\/td>1\u00b72<\/td>0\u00b79 (0\u00b76\u20131\u00b72)<\/td>38<\/td>1\u00b73<\/td>1\u00b70 (0\u00b77\u20131\u00b73)<\/td><\/tr>
Eye, ear, nose, and mouth infections<\/td>26<\/td>0\u00b79<\/td>0\u00b77 (0\u00b74\u20131\u00b70)<\/td>32<\/td>1\u00b71<\/td>0\u00b78 (0\u00b76\u20131\u00b72)<\/td><\/tr>
Other infections*<\/a><\/td>19<\/td>0\u00b76<\/td>0\u00b75 (0\u00b73\u20130\u00b78)<\/td>21<\/td>0\u00b77<\/td>0\u00b76 (0\u00b74\u20130\u00b79)<\/td><\/tr>
Surgical site infections<\/td>10<\/td>0\u00b73<\/td>0\u00b73 (0\u00b71\u20130\u00b75)<\/td>10<\/td>0\u00b73<\/td>0\u00b73 (0\u00b71\u20130\u00b75)<\/td><\/tr>
Bloodstream infections<\/td>10<\/td>0\u00b73<\/td>0\u00b73 (0\u00b72\u20130\u00b75)<\/td>11<\/td>0\u00b74<\/td>0\u00b73 (0\u00b71\u20130\u00b75)<\/td><\/tr>
Unexplained febrile episodes<\/td>4<\/td>0\u00b71<\/td>0\u00b71 (0\u00b70\u20130\u00b73)<\/td>4<\/td>0\u00b71<\/td>0\u00b71 (0\u00b70\u20130\u00b73)<\/td><\/tr>
All<\/td>501<\/td>16\u00b75<\/td>14\u00b71 (10\u00b79\u201318\u00b71)<\/td>609<\/td>20\u00b71<\/td>18\u00b78 (13\u00b76\u201322\u00b73)<\/td><\/tr><\/tbody><\/table>
HAI=health-care-associated infection. RTI=respiratory tract infection. UTI=urinary tract infection.
*Includes HAIs that did not meet any specific case definitions used in the study.<\/figcaption><\/figure>\n\n\n\n

Table 3. Ratio of deaths per 100 residents at 7 days and 30 days after HAI onset, by HAI type<\/p>\n\n\n\n

Empty Cell<\/td>7-day deaths<\/strong><\/th>30-day deaths<\/strong><\/th><\/tr>
Empty Cell<\/td>n<\/th>Crude ratio*<\/a><\/th>Estimated ratio (95% CI)<\/th>n<\/th>Crude ratio*<\/a><\/th>Estimated ratio (95% CI)<\/th><\/tr><\/thead>
RTIs<\/td>51<\/td>1\u00b77<\/td>1\u00b77 (1\u00b73\u20132\u00b72)<\/td>96<\/td>3\u00b72<\/td>3\u00b72 (2\u00b76\u20133\u00b79)<\/td><\/tr>
UTIs<\/td>9<\/td>0\u00b73<\/td>0\u00b73 (0\u00b72\u20130\u00b76)<\/td>30<\/td>1\u00b70<\/td>1\u00b70 (0\u00b77\u20131\u00b74)<\/td><\/tr>
COVID-19<\/td>5<\/td>0\u00b72<\/td>0\u00b72 (0\u00b71\u20130\u00b74)<\/td>16<\/td>0\u00b75<\/td>0\u00b75 (0\u00b73\u20130\u00b79)<\/td><\/tr>
Gastrointestinal infections<\/td>5<\/td>0\u00b72<\/td>0\u00b72 (0\u00b71\u20130\u00b74)<\/td>7<\/td>0\u00b72<\/td>0\u00b72 (0\u00b71\u20130\u00b75)<\/td><\/tr>
Skin and soft-tissue infections<\/td>4<\/td>0\u00b71<\/td>0\u00b71 (0\u00b71\u20130\u00b74)<\/td>18<\/td>0\u00b76<\/td>0\u00b76 (0\u00b74\u20130\u00b79)<\/td><\/tr>
Eye, ear, nose, and mouth infections<\/td>4<\/td>0\u00b71<\/td>0\u00b71 (0\u00b71\u20130\u00b74)<\/td>8<\/td>0\u00b73<\/td>0\u00b73 (0\u00b71\u20130\u00b75)<\/td><\/tr>
Unexplained febrile episodes<\/td>4<\/td>0\u00b71<\/td>0\u00b71 (0\u00b71\u20130\u00b74)<\/td>6<\/td>0\u00b72<\/td>0\u00b72 (0\u00b71\u20130\u00b74)<\/td><\/tr>
Other infections\u2020<\/sup><\/a><\/td>2<\/td>0\u00b71<\/td>0\u00b71 (0\u00b70\u20130\u00b73)<\/td>7<\/td>0\u00b72<\/td>0\u00b72 (0\u00b71\u20130\u00b75)<\/td><\/tr>
Bloodstream infections<\/td>1<\/td>0\u00b70<\/td>0\u00b70 (0\u00b70\u20130\u00b72)<\/td>2<\/td>0\u00b71<\/td>0\u00b71 (0\u00b70\u20130\u00b73)<\/td><\/tr>
All<\/td>85<\/td>2\u00b78<\/td>2\u00b70 (1\u00b78\u20133\u00b71)<\/td>190<\/td>6\u00b73<\/td>7\u00b70 (4\u00b76\u20138\u00b73)<\/td><\/tr><\/tbody><\/table>
RTI=respiratory tract infection. UTI=urinary tract infection.
*11 values missing.
\u2020Includes HAIs that did not meet any specific case definitions used in the study.<\/figcaption><\/figure>\n\n\n\n

<\/p>\n\n\n\n

Interpretation<\/h3>\n\n\n\n

This study shows the high incidence of HAIs among LTCF residents in EU or EEA countries, with more than one in two residents experiencing at least one HAI, and with RTIs and UTIs accounting for almost half of all observed HAIs.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

European Centre for Disease Prevention and Control.<\/p>\n","protected":false},"excerpt":{"rendered":"

Articles Incidence of health-care-associated infections […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29109"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29109"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29109\/revisions"}],"predecessor-version":[{"id":29110,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29109\/revisions\/29110"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29109"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29109"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}