Approximately 2.1 million infections occur annually in acute care hospitals and 1.5 million occur in nursing homes, according to estimates by the Centers for Disease Control.1 Several surveys of nursing homes2-4 and a recent textbook5 point out that the risk of developing an infection in a nursing home is comparable to the risk of developing a hospital-acquired infection, about 5% to 10% per year. Nursing home beds are categorized as skilled nursing beds or intermediate care beds. Residents in skilled care beds require more intensive nursing, and presumably have a greater risk of developing an institutionally acquired (nosocomial) infection. However, reliable data on comparative infection rates are lacking.
Elderly residents of nursing homes are vulnerable to infections because of an age-related waning of immunity, and because of multiple medical problems (eg, cancer, diabetes mellitus, peripheral vascular disease, and incontinence) and therapeutic interventions (eg, urinary catheters and steroid therapy).