Common infections in nursing homes: a review of current issues and challenges Ana Montoya1 and Lona Mody* 1University of Michigan, Division of Geriatrics, MI, USA Abstract Over 1.5 million people live in 16,000 nursing homes in the USA and experience an average of 2 million infections a year. Infections have been associated with high rates of morbidity and mortality, rehospitalization, extended hospital stay and substantial healthcare expenses. Emerging infections and antibiotic-resistant organisms in an institutional environment where there is substantial antimicrobial overuse and the population is older, frailer and sicker, create unique challenges for infection control. This review discusses the common infections, challenges, and a framework for a practical infection prevention program. Keywords antibiotic-resistant organisms; infection control program; infection prevention; infections; multidrug-resistant organisms; nursing home Impact of infections in nursing homes Over 1.5 million people live in 16,000 nursing homes (NHs) in the USA, according to the 2004 National Nursing Home Survey. More than 88% of these people are 65 years of age and older, and 45% are age 85 years and older [1]. It is estimated that the number of people who will require NH care in the USA will reach 5.3 million by 2030 [2]. The acuity of illness in this population has increased substantially in the last decade, as has the risk of acquiring new infections. Although recent estimates are lacking, approximately 2 million infections occur in US NHs each year [3]. In addition, a point prevalence survey revealed that the prevalence of NH-associated infections on the day of the survey was 5.2% in Veterans Administration (VA) Community Living Center (CLC) facilities in the USA [4]. Internationally, a 3-year study in The Netherlands reported a prevalence of healthcareassociated infections of 6.7% in 2007, 7.6% in 2008 and 7.6% in 2009, ranging from 0 to 32.4% between NHs [5]. Infections in the NH population have been associated with high rates of morbidity and mortality, rehospitalization, extended hospital stay and substantial healthcare expenses. Risk factors that predispose older adults to infections have been well described and include the presence of indwelling devices, recent admission to an acute care facility, functional *Author for correspondence: University of Michigan, Division of Geriatrics and Geriatrics Research Education and Clinical Center, Veteran Affairs Ann Arbor Healthcare System, 11-G Geriatrics Research Education and Clinical Center, 2215 Fuller Rd, Ann Arbor, MI 48105, USA, Tel.: +1 734 845 3072, Fax: +1 734 845 3298, lonamody@umich.edu. Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. No writing assistance was utilized in the production of this manuscript. NIH Public Access Author Manuscript Aging health. Author manuscript; available in PMC 2012 December 20. P