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[Infection control in long-term care facilities for the elderly].

BACKGROUND
In Norway, around 20 % of the elderly live in long-term care facilities. The risk of acquiring a nosocomial infection increases by age and the consequences of infections become more severe. This article describes the epidemiology of nosocomial infections and the use of antibiotics in long-term care facilities. Infection control measures are recommended.


MATERIAL AND METHODS
We used data from the national prevalence surveys of nosocomial infections and from the national surveillance system for communicable diseases. In addition we reviewed current literature.


RESULTS
The prevalence of nosocomial infection is similar in hospitals and long-term care facilities in Norway, between 5 % and 10 %. Legal regulations require all health institutions in Norway to have an infection control programme, but little attention has been given to prevention of nosocomial infections in long-term care facilities. Less than 50 % of them have implemented the mandatory infection control programme. The vaccination coverage for influenza is only about 30 %. The coverage of pneumococcal vaccination is even lower.


INTERPRETATION
The following actions are recommended for all long-term care facilities: improved hand hygiene by introducing hand disinfection, implementation of infection control programmes, and improved coverage of pneumococcal and influenza vaccination. Employing more health care personnel, nurses as well as doctors, should be a goal.