Specific features of nosocomial infections in elderly patients admitted toa General Hospital. Five annual prevalence surveys.

Specific features of nosocomial infections in patients aged 70 years or old er admitted to a short-term care medical department in a 400-bed general ho spital were studied to assist in designing nosocomial infection control pro grams for this population. Data from five annual prevalence surveys were ev aluated retrospectively. The 517 patients aged 70 years or older were compa red to the 1093 patients younger than 70 years. The older patients were mor e likely to have risk factors for nosocomial infections including severe di sease (36.2% vs 19.1%; P<10(-6)), referral from another department (24.6% v s 17.5%; P<0.01), a long hospital stay duration (8.5 days vs 3.5 days), mec hanical ventilation (4.3% vs 1.6%; P<0.01), an indwelling urinary catheter (12.0% vs 4.0%; P<10(-7)), and a long median duration of urinary catheteriz ation (6 days vs 2 days). The prevalence of nosocomial infections was incre ased nearly two-fold in older patients (10.3% vs 5.6%; P<0.01), although th e difference was statistically significant only for urinary tract infection s (5.4% vs 1.4%. P<10(-5)), particularly in patients without urinary cathet ers. After exclusion of all patients with urinary tract infections, the pre valence of nosocomial infections was similar in the older and younger patie nts (4.3% vs 3.7%) despite a persistently higher frequency of risk factors for nosocomial infection in the older group. These results indicate that ur inary tract infection should be the main target of programs aimed at minimi zing nosocomial infection in elderly patients admitted to short-term care f acilities. Faultless technique is essential during urinary catheter inserti on. Nigh-quality nursing care contributes substantially to the prevention o f urinary tract infection in noncatheterized patients with urinary incontin ence or neurologic disorders.