Infections and infection risk in residents of long-term care facilities: a review of the literature, 1970-1984.

We reviewed the English-language peer-reviewed journals and the Centers for Disease Control's Morbidity and Mortality Weekly Reports between 1970 and 1984 presenting information about infections and infection risk in residents of long-term care facilities. More than 50 articles met review criteria. Approximately one third of the articles were reports of outbreaks, primarily of respiratory and gastrointestinal infections. Seven articles reported rates for several infection sites, but most rates were not directly comparable to one another because numerators and/or denominators were different. Many of the studies have been done in Veterans Administration hospitals with largely male populations, which may limit their applicability to freestanding long-term care facilities with largely female clients. This review establishes the need for high-quality observational studies of infections in long-term care facilities. Such studies are needed before intervention studies can be done to measure the effect of manipulation of risk factors on infection outcome.