Results of an Italian multi-long-term care facilities survey on diagnostic, therapeutic, and infection control topics: state of the art and future perspective

Background and Aims: current trends in the world’s demographic structure indicate increasing requirements for chronic and Long-Term Care Facilities (LTCFs). As the above settings may act as reservoirs for Multidrug-Resistant Organisms (MDROs), it is essential to acquire information about diagnostic, therapeutic, and infection control practices, aiming to optimize strategies for the near future. Materials and Methods: the annual survey form for assessment of the MDRO management in LTCFs and Residential Homes (RHs) for non-self-sufficient elderly people, promoted by the Centers for Disease Control (CDC), and adapted by the version of the American National Healthcare Safety Network, was sent to LTCFs healthcare operators by the AMCLI GLISTer Working Group. Topics considered were interactions with clinical microbiology laboratories, infection prevention/control and antibiotic stewardship practices, and electronic medical records data availability. Results and Conclusions: sixteen structures, mostly from 120 to 280 beds, took part in the survey. We registered that i) MDRO colonization screening is usually not adopted in Italian LTCFs for new admissions (14; 87,5%) at present, and ii) microbiological results are usually provided by an external laboratory service. Furthermore, infection control interventions are regularly adopted, and antibiotic prescriptions are registered only in 62,5% and 75% of structures, respectively. About 70% of facilities do not have a strategy for antibiotic use optimization. Planning of 1^st/2^nd/3^rd level MDRO surveillance programs, enhanced training activities, and improved antibiotic consumption control, whether for prophylaxis, empirical, and targeted therapy, appears of paramount importance in the complex reality of LTCFs.