Global Surveillance of Healthcare-Associated Infections in Long-Term Care Facilities: A Narrative Review

Healthcare-associated infections (HAIs) in long-term care facilities (LTCFs) are a public health problem worldwide. The aim of this narrative review is to summarize and to provide a comprehensive overview of the current surveillance methods used in LTCFs. We conducted a search of the PubMed database starting from 2000 onward. We found 324 articles that were systematically evaluated by the titles, abstracts, and full texts, and we selected 42 records. These articles were dispersed across North America, Europe, Australia, and Asia. We identified articles describing the results from active or passive surveillance and from a point prevalence study (PPS). The most frequently used method was PPSs in 30 studies, followed by 12 articles reporting active surveillance results and 3 articles describing active surveillance findings. The case definitions applied in 16 articles were those provided by the Centers for Disease Control and Prevention, followed by the McGeer and European Centre for Disease Prevention and Control definitions in 15 and 13, respectively. Twenty-six studies described the method used to calculate the HAI indicator (incidence, incidence density, or prevalence). The articles on PPSs reported prevalence per 100 patients (22 articles), whereas those on active and passive surveillance reported the incidence density per 1000 patient-days. PPSs effectively identified HAIs in LTCFs through standardized data collection and essential interpretive information. The variability in surveillance methods, case definitions, HAI types, and indicator calculation approaches highlights the need for standardized surveillance protocols and methodologies in LTCFs worldwide. Furthermore, these findings emphasize the importance of implementing appropriate surveillance systems and targeted public health measures to effectively address the specific needs and vulnerabilities of the LTCF population in our country.