Healthcare-Associated Infections and Impact of Antibiotic Resistance in Long-Term Care Facilities

老齡化引發的醫療議題已成為世界各國的重要問題。失能人口有顯著提高以後，需要長期護理的老人也越來越多。在美國，已經超過150萬居民住在養老院。根據世界衛生組織的定義，台灣在1993年已經成為一個老齡化社會，並於2012年約29萬名老人需要長期護理機構的照顧，超過在台灣十分之一的總體老年人口數。人口老齡化與失能老人的比例越來越高已經是全球性的現象。然而長期護理機構(以下簡稱長照)的居民在照護過程中跟急性護理醫院相似仍然會有醫療機構相關感染的危險。這個研究有兩個主要目的。首先，我們探討全球長照的流行病學。其次，我們將描述長照間抗生素抗藥性的狀況。在長照感染中，尿路感染是最常見的，其次是呼吸道，軟組織和胃腸道的感染。不同的細菌存在於各個不同的感染部位。目前關鍵是要在發展監測與控制長照機構內感染的政策。監測系統可以協助長照醫護人員在早期發現亞急性住民的臨床狀態。建立地方流行病學數據可以提供長照住民需要時候選擇抗生素的參考；目前，上述資料在台灣仍不齊全。需要共同制訂一個長照感染監測系統和長照抗生素管理政策，並且期待在長照內，減少發生機構內感染與減少產生抗藥性菌株，可以提高長照住民照護的品質。

關鍵字

醫療照顧相關感染；抗生素；抗藥性；長期照護機構

並列摘要

Population aging has become a pressing healthcare issue worldwide, and the rapid rise in the population of disabled people has triggered an increasing demand for long-term care. In the United States, more than 1.5 million residents live in nursing homes. Based on the definitions of World Health Organization, Taiwan became an aging society in 1993 and will be an aged society by 2017. A 10-year plan for long-term care in Taiwan reported approximately 289,009 elderly people in long-term institutional care in 2012, accounting for over one-tenth of the total elderly population in Taiwan. An aging population marked with an increasing proportion of disabled elderly has emerged as a drastic global healthcare challenge. Long-term care facility (LTCF) residents are at risk of developing healthcare-associated infections similar to those seen in acute care hospital patients. The study incorporates two major purposes: exploring the epidemiology of infectious diseases in LTCFs and examining the antibiotic resistance patterns among LTCF residents to provide a dataset for developing antibiotic stewardship programs for LTCFs. Among infections in LTCFs, urinary tract infections are most prevalent, followed by respiratory tract, soft tissue, and gastrointestinal infections. Different bacteria are present at each infection site. It is imperative for LTCFS to develop infection control policies. Infection surveillance systems can be expected to assist healthcare workers in early detection of subclinical conditions. Establishing local epidemiological datasets in LTCFs is also critical for choosing antibiotics; however, these data remain incomplete in Taiwan. It is necessary to develop a LTCF infection surveillance system and antibiotic control policy in order to improve the quality of care in LTCFs.

並列關鍵字

healthcare-associated infections ； antibiotics ； resistant ； long-term care facilities

國際替代計量

Healthcare-Associated Infections and Impact of Antibiotic Resistance in Long-Term Care Facilities

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