Nosocomial infections among patients in a long-term care facility: spectrum, prevalence, and risk factors.

During a 6-month period data were collected on 460 patients residing on the long-term care division of this 1200-bed county hospital. The purpose was to determine prevalence and spectrum and to identify risk factors for skin infections, urinary tract infections, respiratory infections, and sepsis. Overall, the prevalence of nosocomial infections among 460 patients was 12%. Patients with infections had an average of 2.8 diagnoses of their underlying disease compared to patients without infections, who only had 1.8 diagnoses. Specific risk factors were identified. Skin infections were more common in patients who were nonambulatory, diabetic, malnourished, and incontinent of urine and feces, whereas respiratory infections were more common in patients who were smokers or had chronic obstructive lung disease and had not received pneumococcal vaccine. Thirteen percent of patients with an indwelling urinary catheter had symptomatic urinary tract infections, whereas 100% had asymptomatic bacteriuria.