A Retrospective Review of Nosocomial Infections in an Acute Rehabilitative and Chronic Population at a Large Skilled Nursing Facility

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Abstract
This study was undertaken to analyze infection rate, risk for acquisition of infection, and spectrum of infectious disease in two distinct sub-populations within a large, metropolitan, long-term care skilled nursing facility (LTCSNF). A retrospective chart review over an 18-month period. A large, metropolitan LTCSNF. 786 acute rehabilitative patients and 554 chronic patients. The study compared infection rate, risk for acquisition of infection, and the microbiology of the most common infections in the two sub-populations. Analyses comparing the infection rate in the rehabilitative population with the infection rate in the chronic population were performed by multiple regression. The dependent variable in these analyses was the number of infections. The length of time that the patient was at risk for infection was included as a covariate. Approximately 75% of patients in both groups were women. The median age was 80 years in the rehabilitative group, 85 years in the chronic group. Urinary tract infection, pneumonia, skin/soft tissue infection were the most common infections in both groups. Five hundred forty-seven patients in the rehabilitative group and 479 patients in the chronic group had three or more underlying diseases. Enterobacteriaceae organisms were the most common isolates in urinary tract infectious episodes in both groups; mixed flora were the most common isolates for pneumonia and skin/soft tissue episodes in both groups. The calculated rate of infection for the rehabilitative and chronic groups was not significantly different (P = > 0.05). In concordance with other studies, urinary tract infection, respiratory infections, and skin and soft tissue infections were the most common in the long-term care facility. Analyses of two distinct populations within a single, large, teaching nursing facility revealed, however, that the rate of infection was not significantly different between the groups and that length of stay or presence of underlying disease was not predictive of infection.

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