Prevalence of infections in residential care homes for the elderly in Hong Kong.

OBJECTIVES: To study the prevalence of commonly occurring infections among residents of residential care homes for the elderly and their associated risk factors. DESIGN: Point prevalence survey. SETTING: Residential care homes for the elderly in Hong Kong. PARTICIPANTS: Residential care homes for the elderly were treated as a cluster and about 30% of the residents from each home were selected by systematic sampling with bed numbers ending with the digits of 2, 5, and 8. Selected residents were invited to participate. RESULTS: Data from 1603 residents aged 60 years or older from 43 residential care homes for the elderly were analysed. Most (85%) of the residents had underlying medical problems and 55% had more than one problem. The overall prevalence of infection among these residents was 5.7% (95% confidence interval, 4.2-7.1%). The three most common infections were: common cold or pharyngitis (1.9%; 95% confidence interval, 0.9-3.0%), skin and soft-tissue infections (1.4%; 0.5-2.4%), and symptomatic urinary tract infections (0.6%; 0.2-0.9%). Being 'bed-ridden' was a significant risk factor for skin and soft-tissue infections (odds ratio=3.1; 95% confidence interval, 1.4-6.9). Presence of a urinary catheter was a significant risk factor for symptomatic urinary tract infections (odds ratio=62.8; 95% confidence interval, 18.2-217.0). Chronic obstructive pulmonary disease was a significant risk factor for lower respiratory tract infection (odds ratio=16.5; 95% confidence interval, 3.4-81.2). CONCLUSIONS: This is the first territory-wide prevalence survey of infections among residents in residential care homes for the elderly in Hong Kong. The data retrieved enable us to target our infection control programme in residential care homes for the elderly to those with a high prevalence. So as to monitor seasonal and secular trends, targeted regular surveillance is needed for better profiling of the actual situation.