National surveillance of health care-associated infections in Egypt: Developing a sustainable program in a resource-limited country.

Autor: Talaat M; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt. Electronic address: maha.m.talaat.ctr@mail.mil., El-Shokry M; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt; Ain Shams University Hospitals, Cairo, Egypt., El-Kholy J; Cairo University Hospitals, Cairo, Egypt., Ismail G; Ain Shams University Hospitals, Cairo, Egypt., Kotb S; Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt., Hafez S; Alexandria University Hospitals, Alexandria, Egypt., Attia E; Ministry of Health and Population, Cairo, Egypt., Lessa FC; Centers for Disease Control and Prevention, Atlanta, GA.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2016 Nov 01; Vol. 44 (11), pp. 1296-1301. Date of Electronic Publication: 2016 Jun 20.
DOI: 10.1016/j.ajic.2016.04.212
Abstrakt: Background: Health care-associated infections (HAIs) are a major global public health concern. The lack of surveillance systems in developing countries leads to an underestimation of the global burden of HAI. We describe the process of developing a national HAI surveillance program and the magnitude of HAI rates in Egypt.
Methods: The detailed process of implementation of a national HAI surveillance program is described. A 3-phase surveillance approach was implemented in intensive care units (ICUs). This article focuses on results from the phase 2 surveillance. Standard surveillance definitions were used, clinical samples were processed by the hospital laboratories, and results were confirmed by a reference laboratory.
Results: Ninety-one ICUs in 28 hospitals contributed to 474,544 patient days and 2,688 HAIs. Of these, 30% were bloodstream infections, 29% were surgical site infections, 26% were pneumonia, and 15% were urinary tract infections. Ventilator-associated pneumonia had the highest incidence of device-associated infections (4.3/1,000 ventilator days). The most common pathogens reported were Klebsiella spp (28.7%) and Acinetobacter spp (13.7%). Of the Acinetobacter spp, 92.8% (157/169) were multidrug resistant, whereas 42.5% (151/355) of the Klebsiella spp and 54% (47/87) of Escherichia coli were extended-spectrum β-lactamase producers.
Conclusions: Implementation of a sustainable surveillance system in a resource-limited country was possible following a stepwise approach with continuous evaluation. Enhancing infection prevention and control programs should be an infection control priority in Egypt.
(Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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