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Important sites and pathogens causing infections in long-term care facilities

Michael J Richards, MD, FRACP
Rhonda L Stuart, MBBS, FRACP, PhD
Section Editor
Anthony Harris, MD, MPH
Deputy Editor
Elinor L Baron, MD, DTMH


Long-term care facilities (LTCFs) provide a unique environment favoring the transmission of infections to residents. Such infections are a form of non-nosocomial (outpatient) healthcare associated infections as opposed to hospital-acquired (nosocomial) healthcare associated infections.

As the population ages and technology improves to care for patients with previously fatal conditions, both the number and proportion of persons in LTCFs will increase. The incidence of infections in LTCFs is comparable to that in acute care hospitals in both total number and rate of infections [1]. Residents of these institutions are subject to infections circulating in the community, those normally considered to be nosocomial, and those unique to persons with a wide range of disabilities.

Specific sites and pathogens responsible for infections in LTCFs as well as measures to prevent or control these infections will be reviewed here. The general issues involved in infection control in these facilities are discussed separately. (See "Principles of infection control in long-term care facilities".)

The IDSA clinical practice guidelines for the evaluation of fever and infection in long-term care facilities, along with other IDSA guidelines, are available at the IDSA's web site [2].


Sites of infection that have particular importance in LTCFs include respiratory tract infection, gastroenteritis, skin and soft tissue infection, and urinary tract infection. Together these infections represent 94 percent of infections seen in LTCFs [3].


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Literature review current through: Sep 2015. | This topic last updated: Feb 19, 2014.
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