Wintaco Luz M, Quintero-Lesmes Doris C, Vargas-Soler José A, Barrera Diego M, Palacio Laura N, Granados Ulises, Uribe Luis G
Universidad del Rosario, Bogotá, Colombia. Hospital Internacional de Colombia, Bucaramanga, Colombia.
Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.
Rev Cuid. 2024 May 30;15(1):e3624. doi: 10.15649/cuidarte.3624. eCollection 2024 Jan-Apr.
Healthcare-associated infections pose a significant challenge, contributing to hospital morbidity and mortality.
To describe the behavior of Healthcare Associated Infections before and during the pandemic reported to a high-complexity health institution in Colombia.
In our retrospective observational study on Healthcare-Associated Infections (HAIs), we analyzed data from all in patients diagnosed with HAIs between 2018 and 2020. This included clinical, demographic, microbiological, and microbial susceptibility information collected from the Committee on Nosocomial Infections' prospective database. Data from 391 isolates were obtained using Whonet software for antimicrobial resistance surveillance.
We found 504 cases of HAIs (2018-2020) with an overall in-hospital infection rate of 2.55/1000 patient days. The median age for pediatric patients was 5 years, and for adults, 56 years, with 57% male. The leading admission diagnoses were oncologic disease complications (31%). Bacteremia had a 30-day mortality rate of 13%, predominantly catheter-associated (37%). Gram-negative bacilli, notably Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, represented 58% cases of HAI.
The critical need for specific interventions and antimicrobial management to control HAIs, especially given the challenges posed by the COVID-19 pandemic, is highlighted.
This is the first report on HAIs incidence at a tertiary hospital in Bucaramanga, Santander (Colombia). Bacteremia was predominant; 75% of HAIs patients had comorbidities. Gram-negative bacilli prevailed; a notable rise in ICU respiratory infections occurred during the 2020 COVID-19 pandemic. Resistance to cephalosporins and carbapenems was prevalent.
医疗保健相关感染构成了重大挑战，会导致医院发病率和死亡率上升。
描述在大流行之前和期间，向哥伦比亚一家高复杂性医疗机构报告的医疗保健相关感染的情况。
在我们关于医疗保健相关感染（HAIs）的回顾性观察研究中，我们分析了2018年至2020年间所有诊断为HAIs的住院患者的数据。这包括从医院感染委员会的前瞻性数据库收集的临床、人口统计学、微生物学和微生物敏感性信息。使用Whonet软件获取391株分离株的抗菌药物耐药性监测数据。
我们发现了504例HAIs病例（2018 - 2020年），总体医院感染率为2.55/1000患者日。儿科患者的中位年龄为5岁，成人患者为56岁，男性占57%。主要的入院诊断是肿瘤疾病并发症（31%）。菌血症的30天死亡率为13%，主要是导管相关菌血症（37%）。革兰氏阴性杆菌，尤其是肺炎克雷伯菌、大肠杆菌和铜绿假单胞菌，占HAIs病例的58%。
强调了采取特定干预措施和抗菌药物管理以控制HAIs的迫切需求，特别是考虑到COVID - 19大流行带来的挑战。
这是关于桑坦德省布卡拉曼加市一家三级医院（哥伦比亚）HAIs发病率的首份报告。菌血症占主导；75%的HAIs患者患有合并症。革兰氏阴性杆菌占优势；在2020年COVID - 19大流行期间，重症监护病房的呼吸道感染显著增加。对头孢菌素和碳青霉烯类药物的耐药性普遍存在。
