First nationwide point-prevalence survey on healthcare-associated infections and antibiotic use in long-term care facilities, Switzerland, September 2024

INTRODUCTIONData for healthcare-associated infections (HAI) and antibiotic use in long-term care facilities (LTCF) in Switzerland are lacking but are necessary to take actions.AIMWe aimed to estimate HAI prevalence and antibiotic use and to record existing structure and process indicators in the area of infection prevention/antibiotic use in Swiss LTCF.METHODSWe invited all Swiss LTCF for this PPS in September 2024 using the adapted Healthcare-Associated Infections in European Long-Term Care Facilities (HALT)-4 protocol. The proportion of residents with HAI and systemic antibiotic treatment was calculated for a representative sample, stratified by language region and size. We assessed resident-level and institutional risk factors for HAI in all participating institutions, using random-effects logistic regression.RESULTSWe included 94 LTCF (7,244 residents), whereof 49 LTCFs (3,375 residents) belonged to the representative sample. Median age of residents in the representative sample was 87 years (range: 36-107) and 2,334 (69.2%) were female. Prevalence of HAI was 2.2% (95% confidence interval (CI): 1.7-2.7); 2.7% (95% CI: 2.2-3.3) were receiving antibiotic treatment, with highest use in LTCF in French-speaking cantons (5.9%; 95% CI: 4.2-7.5). Urinary tract (46%) and respiratory infections (20%) were most common, aminopenicillins (26%) and nitrofurantoin (19%) the most commonly used antimicrobials. The strongest independent risk factor for HAI was presence of urinary catheters (adjusted odds ratio = 2.65; 95% CI: 1.71-4.11).DISCUSSIONPrevalence of HAI and antibiotic use in Swiss LTCFs were comparable to the European average from 2023/24. There are regional differences in antibiotic consumption. Urinary catheterisation, potentially modifiable, was the most important risk factor for HAI.