NSIH-LTCF - Healthcare-associated infections in long-term care facilities

Last updated on 5-10-2023 by Katrien Latour
Project duration:
January 1, 2005
Project with no end date

In short

When people with care needs are no longer able to live at home on their own, (long-term) admission to a long-term care facility (e.g. a nursing home) becomes necessary. During the care process, there is a risk that these residents will acquire an infection, referred to as a healthcare-associated infection. Based on various studies, we document these healthcare-associated infections, the associated antibiotic treatments and the problem of antibiotic resistance (bacteria that become insensitive to antibiotics) in these healthcare institutions. 

Project description

Healthcare-associated infections are infections that occur after healthcare exposure and often, but not always, result from this exposure. Residents in long-term care facilities are more likely to acquire healthcare-associated infections because of the long length of stay and, therefore, also the exposure to care in these institutions. Moreover, the residents in these institutions are often elderly. They are especially vulnerable due to a reduced immune system, underlying disorders and/or physical limitations. 

Infections in these individuals are often more complicated and are frequently treated with antibiotics. Frequent and incorrect use of these antibiotics can lead to antibiotic resistance. In the case of antibiotic resistance, the bacteria have become insensitive to antibiotics and these medicines are therefore no longer effective. During the course of care, frequent contacts between residents and care staff also increase the chance of infections and/or resistant germs being transmitted.  

For several years, a great deal of effort has been put into documenting the problem of healthcare-associated infections, antibiotic use and antibiotic resistance in Belgian long-term care facilities

Healthcare-associated infections, antibiotic resistance and the use of antimicrobials in long-term care facilities

Sciensano has already organized three (2005, 2011 and 2015) national prevalence studies (measurement of a disease or condition in a particular population at a particular time) in order to document the prevalence of carriage of methicillin-resistant Staphylococcus aureus (MRSA) and other resistant germs in Belgian nursing homes.

Following studies on the use of antimicrobials in nursing homes (ESAC NH), Sciensano, in collaboration with the European Center for Disease Prevention and Control (ECDC), is organizing prevalence studies in European long-term care facilities. The aim of these ‘Healthcare-associated Infections and Antimicrobial use in Long-Term Care Facilities’ (HALT) studies is to measure the occurrence of healthcare-associated infections and the use of antimicrobials in long-term care facilities using a standardized methodology. 

Three European HALT studies have already taken place (2010, 2013 and 2016–2017). HALT PSY took place in 2017: a study specifically aimed at psychiatric hospitals and psychiatric wards in acute hospitals in Belgium. In 2021, Sciensano organized a national HALT study. The European HALT-4 study takes place from 1 October until 30 November 2023 in Belgium. All long-term care facilities can participate in the survey. 

If you are interested in participating or if you would like to receive more information, please contact us at halt@sciensano.be.

The development of COVID-19 in Belgian long-term care facilities

Following the corona crisis, Sciensano, in collaboration with the regional authorities, is also monitoring the development of COVID-19 in Belgian long-term care facilities (mainly nursing homes). Via this surveillance, we measure:

  • the incidence (number of new cases in a given period) and prevalence (number of cases at a given time) of confirmed COVID-19 cases in residents and members of staff
  • the number of COVID-19 hospital admissions and deaths among residents
  • the absenteeism due to COVID-19 among the staff.

In addition, the surveillance aims to identify potential infection clusters in these institutions so that the regional authorities can investigate them further. 

Finally, Sciensano - in collaboration with the Flemish Institute for Technological Research (VITO) — carried out the AIRCO study. This study ran from October 2021 to October 2022. In the context of this study, we measured ventilation and indoor air quality in 11 Belgian nursing homes using measuring devices in five different rooms. We also took air samples and samples from ventilation grilles. In addition, we asked questions about and observed the ventilation habits and infection prevention measures in the participating nursing homes.  


Carriage of resistant bacteria in Belgian nursing homes

The reports below contain the results of the three national prevalence studies (2005, 2011 and 2015) of the carriage of resistant bacteria in Belgian nursing homes. 


You can find the scientific publications relating to these studies at the bottom of this page under ‘Associated publications’.

Healthcare-associated infections and use of antimicrobials in long-term care facilities (HALT studies)

The reports below contain the national results of the four HALT studies on healthcare-associated infections and antimicrobials use in long-term care facilities (2010, 2013, 2016 and 2021). 

Go to the ECDC website for more information on the European results.


You can find the scientific publications relating to these HALT studies at the bottom of this page under ‘Associated publications’.

Surveillance of the use of microbials in nursing homes (ESAC-NH)

The reports below contain the results of the surveillance of antimicrobial use in nursing homes


You can find the scientific publications relating to this surveillance at the bottom of this page under ‘Associated publications’ 

COVID-19 in long-term care facilities

The situation in long-term care facilities can be observed via: 

Consult the ‘COVID-19 surveillance in residential institutions’ protocol.

You can find the scientific publications relating to this surveillance at the bottom of this page under ‘Associated publications’. 

Other reports

Depending on need, Sciensano has organized various ad hoc projects in Belgian long-term care facilities. The results of these projects can be found below.


Sciensano's project investigator(s):

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