[Surveillance of healthcare associated infections, bacterial resistance and antibiotic consumption in high-complexity hospitals in Colombia, 2011].

Autor: Villalobos AP; Equipo Funcional Infecciones Asociadas a la Atención en Salud, Bogotá, D.C, Colombia., Barrero LI; Equipo Funcional Infecciones Asociadas a la Atención en Salud, Bogotá, D.C, Colombia., Rivera SM; Equipo Funcional Infecciones Asociadas a la Atención en Salud, Bogotá, D.C, Colombia., Ovalle MV; Equipo Funcional Infecciones Asociadas a la Atención en Salud, Bogotá, D.C, Colombia., Valera D; Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C, Colombia.
Jazyk: Spanish; Castilian
Zdroj: Biomedica : revista del Instituto Nacional de Salud [Biomedica] 2014 Apr; Vol. 34 Suppl 1, pp. 67-80.
DOI: 10.1590/S0120-41572014000500009
Abstrakt: Introduction: Preventing healthcare associated infections, especially for resistant microorganisms, is a priority. In Colombia, the surveillance of such events was started through a national pilot study.
Objective: To describe the epidemiology of device-associated infections, bacterial resistance and antibiotic consumption patterns in institutions with intensive care units (ICU), 2011.
Materials and Methods: Descriptive observational study in 10 health institutions from three Colombian provinces: Antioquia, Valle del Cauca, and Bogotá. Surveillance protocols were designed and implemented by trained health professionals in each hospital. A web tool was designed for data reporting and analysis. Infection rates, device-use percentages and antibiotics defined daily dose (DDD) were calculated. Bacterial resistance phenotypes and profiles were reported and analyzed using Whonet 5.6.
Results: The most common event was bloodstream infection (rate > 4.8/1000 catheter-days) followed by ventilator-associated pneumonia (VAP) and catheter-related urinary tract infection, showing a wide variability among institutions. A high consumption of meropenem in the ICU (DDD 22.5/100 beds-day) was observed, as well as a high carbapenem resistance (> 11.6%) and a high frequency of third generation cephalosporins resistance (> 25.6%) in Enterobacteriaceae in ICUs and hospitalization wards. The percentage of methicillin-resistant Staphylococcus aureus was higher in hospitalization wards (34.3%).
Conclusions: This is the first experience in measuring these events in Colombia. It is necessary to implement a national surveillance system aimed at guiding governmental and institutional actions oriented to infection prevention and control, to resistance management and to the promotion of antibiotics rational use, along with a follow-up and monitoring process.
Databáze: MEDLINE