Infection rates

Infection rates in care homes run at about 11% of residents according to a point prevalence survey, and 10% of residents were on antibiotics[i],vi.

The infections being treated were respiratory tract infections (35.1%), urinary tract infections (32.1%) and skin infections (21.8%).

In the UK, approximately 40 in every 100 care homes suffer a gastroenteritis outbreak each year. Norovirus accounts for 65% of gastroenteritis outbreaks[ii].

Infections also have a large impact on staff and their families

A study of a norovirus outbreak showed that residents, staff and staff households were affected. The attack rate (percentage of exposed people who fell ill) was 24% for residents, 46% for staff and 23% for members of staff households[iii].

There are high levels of colonisation by antimicrobial resistant organisms (“super bugs”) in care homes

In the UK, 18% of care home residents are colonised by MRSA.  The rate of colonisation varies internationally; the lowest is Austria (0%)/Germany (5%) and the highest is the USA (23%)[iv].

Infections cause closures to new admissions

In January 2022 nearly half of all care homes were closed to new admissions due to Omicron outbreak[v].

Controlling infection in care homes is very challenging with existing methods

A study found the key risk factors for Infection are: new admissions; admissions from hospitals; use of bank staff.  A further important risk factor for resident infection is staff infection (more so than the other way around)[vi].

Another study found significant challenges in implementing IPC in care homes including staffing skills, education, workloads and work routines.  The study concluded these challenges cannot be properly addressed without resolving the tension between two objectives: maintaining resident quality of life; and enacting good IPC practice – but which can reduce the homely feel of an environment[vii].

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[i] https://www.sciencedirect.com/science/article/abs/pii/S0195670112000059

[ii] https://link.springer.com/article/10.1186/s12879-019-4726-4

[iii] A foodborne norovirus outbreak in a nursing home and spread to staff and their household contacts – PubMed (nih.gov)

[iv] The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis | SpringerLink

[v] https://www.nursinginpractice.com/community-nursing/nearly-half-of-care-homes-closed-to-new-admissions-finds-survey/#

[vi] Vivaldi 1: COVID-19 care homes study report – GOV.UK (www.gov.uk)

[vii] Beyond the control of the care home: A meta-ethnography of qualitative studies of Infection Prevention and Control in residential and nursing homes for older people – PubMed (nih.gov)