Europe warns of "serious deficiencies" in infection prevention in nursing homes.

The European Centre for Disease Prevention and Control (ECDC) warned this Monday of "serious deficiencies" in infection prevention and control measures in long-term care facilities, such as nursing homes , as well as in the optimization of antimicrobial use.

Up to 3.1% of residents in these facilities had at least one healthcare-associated infection, according to a survey conducted by the ECDC between 2023 and 2024 in 18 countries across the European Union and the European Economic Area.

Among the main reported infections are those of the urinary tract, respiratory tract and skin, with 'Escherichia coli' being the most frequent microorganism, followed by 'SARS-CoV-2' , 'Klebsiella pneumoniae' and 'Staphylococcus aereus' .

Despite this, only one in five healthcare-associated infections have been microbiologically confirmed, which is why researchers have expressed concern about the underdiagnosis and undertreatment without definitive evidence.

More than 4% of residents were receiving at least one antimicrobial at the time of the survey, and nearly a third of these were for prophylactic purposes.

Regarding these centers' preparedness to prevent infections and their "prudent" use of antibiotics , the report notes that while all have hand hygiene protocols , one in five relied primarily on handwashing with soap and water, while the others included alcohol-based hand sanitizer as their primary method of hand hygiene.

Despite this, nearly a third of these facilities do not have a regular system for monitoring hand hygiene and providing feedback to staff, and one in five did not have staff trained in infection prevention and control.

Furthermore, less than half had an infection prevention and control committee , nearly 40% lacked an antimicrobial use optimization program, and only one in ten provided training on proper antibiotic prescribing practices.

" Reliable data is the foundation for effective action. This survey demonstrates that we need to better protect residents of long-term care facilities through evidence-based strategies, enhanced surveillance, and a strong commitment to real change," said ECDC Chief Scientist Piotr Kramarz.

Alcohol-based hand sanitizer is recommended as the primary method for hand hygiene.

For all these reasons, the ECDC has urged the health authorities of each country and the managers of nursing homes to strengthen infection prevention and control in these facilities, through staff training , the allocation of additional resources, improved surveillance, and the promotion of clear guidelines and greater awareness.

It has also recommended establishing alcohol-based hand sanitizer as the primary method for hand hygiene, as well as improving antimicrobial prescribing practices, focusing on streamlining the use of prophylactics.

"These measures are essential to protect the health of long-term care residents and curb the spread of antimicrobial resistance across Europe," the ECDC said.