ABSTRACT
The increased risk and severity of infections in the elderly population is well documented, and immunosenescence, the state of dysregulated immune function with aging, is felt to be a significant contributor to this increased risk. However, of more clinical relevance is the even higher risk of nosocomial infections in longterm care facilities (LTCFs). Surveillance ofLTCF-acquired infections by the National Nosocomial Infections Surveillance system has reported a high incidence of 3.82 infections per 1000 resident-days of care, but with significant variability (1). Data vary widely depending on the type of facility, nature of the residents, definitions used for infections, and type of data analysis. Prevalence rates of infection range from 1.6% to 32.7%, and overall incidence rates range from 1.8 to 13.5 infections per 1000 resident-days of care, with equal variability for specific infections such as urinary tract infection or pneumonia. The questions that are raised from these data are: (1) What resident or facility factors contribute to this wide variability of incidence of infections? (2) Can anything be done to reduce the risk of infection by treatment of residents? (3) What impact could changes in infection control policy have on infection rate for a given facility?
