Infections in long-term care: Challenges in an ageing Europe

IF 5.1 2区医学 Q1 NURSING

Intensive and Critical Care Nursing Pub Date : 2026-04-01 Epub Date: 2025-11-08 DOI:10.1016/j.iccn.2025.104271

Jordi Rello , Niccolò Buetti , Hagar L. Mowafy

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引用次数: 0

Abstract

Background

The demographic shift towards an ageing population, especially in Europe, place a significant burden on healthcare systems and increasing demand for long-term care facility (LTCF) services. These facilities provide support to both older individuals and patients with disabilities. Despite their importance, LTCFs continue to face challenges in infection prevention and control (IPC) contributing to increase the burden of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR).

Objective

The aim of this opinion review is to summarize current global and regional IPC guidance applicable to LTCFs and identifies critical gaps that must be addressed to improve residents’ safety.

Discussion

Global and regional organizations including the World Health Organization (WHO), European Centre for Disease Prevention and Control (ECDC), United States Centre for Disease Control and Prevention (CDC), and other professional organizations provides basic IPC recommendations mostly adapted from acute healthcare settings. Despite these valuable resources, major gaps persist, especially within the European context. One of the major gaps is that most of these IPC guidance are adapted from acute care settings without taking into consideration the unique structural and social differences of LTCFs. The inherent heterogeneity of LTCFs within European countries, the scarcity of high-quality studies assessing different IPC interventions across diverse LTCF types, compounded by the limitations in workforce capacity and surveillance gaps further pose critical challenges to effective IPC guidance.

Implications for Clinical Practice

Unified, evidence-based guidelines specifically designed for LTCFs are urgently needed to warrant the safety and equity of service provided to LTCF residents across different countries and sectors. Such a framework must emphasize continuous surveillance, workforce development, and practical, applicable strategies that can be easily incorporated into the unique nature of LTCFs.

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长期护理中的感染：老龄化欧洲的挑战

人口结构向老龄化的转变，特别是在欧洲，给医疗保健系统带来了沉重的负担，并增加了对长期护理设施（LTCF）服务的需求。这些设施为老年人和残疾患者提供支持。尽管它们很重要，但ltcf在感染预防和控制（IPC）方面继续面临挑战，从而增加了卫生保健相关感染（HAIs）和抗菌素耐药性（AMR）的负担。本意见审查的目的是总结当前适用于ltcf的全球和区域IPC指南，并确定必须解决的关键差距，以提高居民的安全。讨论包括世界卫生组织（世卫组织）、欧洲疾病预防和控制中心（ECDC）、美国疾病控制和预防中心（CDC）在内的全球和区域组织以及其他专业组织提供了基本的IPC建议，这些建议大多改编自紧急医疗保健环境。尽管有这些宝贵的资源，但主要的差距仍然存在，特别是在欧洲范围内。其中一个主要差距是，这些IPC指南大多改编自急性护理环境，而没有考虑到长期护理中心独特的结构和社会差异。欧洲国家LTCF的内在异质性，评估不同LTCF类型的不同IPC干预措施的高质量研究的缺乏，再加上劳动力能力的限制和监测差距，进一步对有效的IPC指导构成了严峻的挑战。临床实践的意义迫切需要专门为LTCF设计的统一的循证指南，以保证向不同国家和部门的LTCF居民提供的服务的安全性和公平性。这样的框架必须强调持续的监督、劳动力的发展和实际的、适用的战略，这些战略可以很容易地融入到ltcf的独特性质中。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.