Geographical information system and spatial-temporal statistics for monitoring infectious agents in hospital: a model using Klebsiella pneumoniae complex.

Autor: da Silva PP; Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz - Fundação Oswaldo Cruz, Avenida Brasil, 4365, Pavilhão Leônidas Deane, 6º andar, sala 607, Rio de Janeiro, RJ, 21040-900, Brazil., da Silva FA; Department of Engineering, Hospital Federal Dos Servidores Do Estado (HFSE), Rio de Janeiro, RJ, Brazil.; Rio de Janeiro State University, Rio de Janeiro, Brazil., Rodrigues CAS; Laboratory of Microbiology, HFSE, Rio de Janeiro, RJ, Brazil., Souza LP; Laboratory of Microbiology, HFSE, Rio de Janeiro, RJ, Brazil., de Lima EM; Hospital Infection Control Committee, HFSE, Rio de Janeiro, RJ, Brazil., Pereira MHB; Admitting Office, HFSE, Rio de Janeiro, RJ, Brazil., Candella CN; Department of Engineering, Hospital Federal Dos Servidores Do Estado (HFSE), Rio de Janeiro, RJ, Brazil., de Oliveira Alves MZ; Hospital Infection Control Committee, HFSE, Rio de Janeiro, RJ, Brazil., Lourenço ND; Laboratory of Microbiology, HFSE, Rio de Janeiro, RJ, Brazil., Tassinari WS; Department of Mathematics, The Federal Rural University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.; Evandro Chagas National Institute of Infectious Diseases, FIOCRUZ, Rio de Janeiro, Brazil., Barcellos C; Institute of Scientific and Technological Communication and Information in Health, FIOCRUZ, Rio de Janeiro, RJ, Brazil. christovam.barcellos@icict.fiocruz.br., Gomes MZR; Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz - Fundação Oswaldo Cruz, Avenida Brasil, 4365, Pavilhão Leônidas Deane, 6º andar, sala 607, Rio de Janeiro, RJ, 21040-900, Brazil. marisargomes@ioc.fiocruz.br.; Hospital Infection Control Committee, HFSE, Rio de Janeiro, RJ, Brazil. marisargomes@ioc.fiocruz.br.
Jazyk: angličtina
Zdroj: Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2021 Jun 16; Vol. 10 (1), pp. 92. Date of Electronic Publication: 2021 Jun 16.
DOI: 10.1186/s13756-021-00944-5
Abstrakt: Background: The emergence and spread of antimicrobial resistance and infectious agents have challenged hospitals in recent decades. Our aim was to investigate the circulation of target infectious agents using Geographic Information System (GIS) and spatial-temporal statistics to improve surveillance and control of healthcare-associated infection and of antimicrobial resistance (AMR), using Klebsiella pneumoniae complex as a model.
Methods: A retrospective study carried out in a 450-bed federal, tertiary hospital, located in Rio de Janeiro. All isolates of K. pneumoniae complex from clinical and surveillance cultures of hospitalized patients between 2014 and 2016, identified by the use of Vitek-2 system (BioMérieux), were extracted from the hospital's microbiology laboratory database. A basic scaled map of the hospital's physical structure was created in AutoCAD and converted to QGis software (version 2.18). Thereafter, bacteria according to resistance profiles and patients with carbapenem-resistant K. pneumoniae (CRKp) complex were georeferenced by intensive and nonintensive care wards. Space-time permutation probability scan tests were used for cluster signals detection.
Results: Of the total 759 studied isolates, a significant increase in the resistance profile of K. pneumoniae complex was detected during the studied years. We also identified two space-time clusters affecting adult and paediatric patients harbouring CRKp complex on different floors, unnoticed by regular antimicrobial resistance surveillance.
Conclusions: In-hospital GIS with space-time statistical analysis can be applied in hospitals. This spatial methodology has the potential to expand and facilitate early detection of hospital outbreaks and may become a new tool in combating AMR or hospital-acquired infection.
Databáze: MEDLINE
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