A MAJOR new European study reveals that over half of residents in long-term care facilities (LTCFs) suffer at least one healthcare-associated infection (HAI) each year, underlining a serious and ongoing public health challenge across the continent.
With ageing populations and rising demand for long-term care, infections acquired in care homes pose a growing threat to older adults. This prospective cohort study, coordinated by the European Centre for Disease Prevention and Control (ECDC), tracked HAIs over a 12-month period in a sample of 65 LTCFs across nine EU and EEA countries. Eligible participants were residents expected to stay for the full duration. Researchers collected data through standardised institutional, resident, and HAI questionnaires, and defined infections using ECDC criteria. They estimated infection rates using statistical models that accounted for differences between facilities.
The study followed 3,029 residents from January 2022–May 2023. Participants had a mean age of 80.9 years, and nearly 70% were women. Over the course of the year, 3,763 infections were recorded, affecting 57% of residents. This equates to 124.2 infections per 100 residents and 1.8 infections per 1,000 resident-days. Among the infections, 4.3% resulted in hospitalisation and 4.5% were linked to death. Respiratory tract infections (RTIs) were the most common, comprising 28.9% of all HAIs, including pneumonia (7.3%) and other lower RTIs (10.7%). Urinary tract infections followed at 18.7%. RTIs also carried the highest mortality rate, responsible for 85 of the 154 recorded deaths. Severe COVID-19 cases were relatively rare (1.9%), although milder forms of the virus accounted for 16% of all infections.
The findings show the urgent need to improve infection prevention in care homes, where residents are particularly vulnerable to severe outcomes. As Europe’s population continues to age, targeted strategies to reduce HAIs, particularly respiratory and urinary infections, will be essential to protect elderly patients and ease pressure on healthcare systems.
Reference
Ricchizzi E et al. Incidence of health-care-associated infections in long-term care facilities in nine European countries: a 12-month, prospective, longitudinal cohort study. Lancet Infect Dis. 2025; DOI: 10.1016/S1473-3099(25)00217-8.
