Trends in point-prevalence studies of healthcare associated infections in long-term care facilities: A nationwide surveillance program in Catalonia, Spain (2013-2022).

Background: From 2013 to 2022, annual point-prevalence studies (PPS) of healthcare-associated infections (HAIs) were conducted in 97 long-term care facilities (LTCF) within the VINCat Program in Catalonia, Spain. The objective was to analyze trends in HAIs and antibiotic use to evaluate the burden of HAIs in this setting.

Methods: We compare PPS data from two 5-year periods. Period 1 (2013-2017) involving 50,378 residents and period 2 (2018-2022) involving 65,997 residents. Variables included demographic characteristics, patient conditions, medical devices on the day of PPS and recent surgery. Source of HAI, causative microorganisms, antibiotics and indication were recorded. HAIs were defined according to ECDC criteria.

Results: A total of 116,375 residents were included, median age of 82 years (range: 73-88), 56.7% female. Although severe dependency was more common in period 1, the presence of vascular and urinary catheters increased in period 2. Overall, 9943 (8.5%) residents had one or more HAIs. The HAI prevalence rate significantly decreased from 9.3% in period 1 to 8% in period 2, being urinary tract infections the most prevalent HAI in both periods, followed by respiratory tract infections. Escherichia coli was the most frequently identified microorganism. No significant differences in the prevalence of antibiotic use between periods (11.8 vs 12.1 respectively) were found, although there was a shift toward more targeted prescriptions.

Conclusions: Despite a significant reduction over the study period, the prevalence of HAIs remains high in LTCFs of Catalonia, affecting 8% of residents. Implementation of infection prevention and control interventions are highly required.