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. 2025 Jun 3;14(6):573.
doi: 10.3390/antibiotics14060573.

Surveillance of Healthcare-Associated Infections in Long-Term Care Facilities in Graz, Austria, from 2018 to 2022

Elisabeth König  1 , Miriam Meister  1 , Christian Pux  2 , Michael Uhlmann  2 , Walter Schippinger  2 , Herwig Friedl  3 , Robert Krause  1 , Ines Zollner-Schwetz  1
Affiliations

Surveillance of Healthcare-Associated Infections in Long-Term Care Facilities in Graz, Austria, from 2018 to 2022

Elisabeth König et al. Antibiotics (Basel). .

Abstract

Objectives: This study aimed to evaluate changes in the rate and spectrum of healthcare-associated infections (HCAIs) and to analyse the rate and spectrum of antimicrobial prescriptions in four long-term care facilities (LTCFs) in Graz, Austria, from 2018 to 2022 in a prospective cohort study. Methods: Nursing staff prospectively collected data on HCAIs and antimicrobial prescriptions once a week. Log-linear Poisson models for counts were applied mostly to evaluate the difference effects of the various calendar years compared to the reference year of 2018. Results: A total of 1684 infections were recorded in 720 residents during the study period. The overall annual incidence rate of HCAIs varied over time with a significant increase to 2.86/1000 resident days in 2019 and to 4.09/1000 resident days in 2022, both compared to 2018, p < 0.001. A large peak in respiratory tract infections (RTIs) occurred in winter 2021/2022 due to a large number of SARS-CoV-2 infections in all four LTCFs. Urinary tract infections (UTIs) were the most commonly recorded infections. Beta-lactams were the most frequently prescribed systemic anti-infectives. A statistically significant increase in the rate of beta-lactam prescriptions/1000 resident days occurred between 2018 and 2022 (p = 0.016), whereas a statistically significant decrease in quinolone prescriptions/1000 resident days occurred in the same time period (p < 0.001). Conclusions: The incidence rates of HCAIs varied over time with a significant increase during the COVID-19 pandemic in 2022 compared to 2018. Continued surveillance efforts are necessary to assess the effect of infection control efforts after the pandemic.

Keywords: elderly; nosocomial infections; nursing home; surveillance.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Infection rate per 1000 resident days in five disease categories. Febrile = unexplained febrile illness. GTI = gastrointestinal infection. RTI = respiratory tract infection. Skin = skin and mucosal infections (including infections of the eyes, ears and teeth). UTI = urinary tract infection.
Figure 2
Figure 2
Prescription rates per 1000 resident days for 5 different anti-infective groups from 2018 to 2022.
See this image and copyright information in PMC

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