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Device-Associated Infection Rate and Mortality in Intensive Care Units of 9 Colombian Hospitals: Findings of the International Nosocomial Infection Control Consortium

Published online by Cambridge University Press:  21 June 2016

Carlos Álvarez Moreno ,
Victor D. Rosenthal ,
Narda Olarte ,
Wilmer Villamil Gomez ,
Otto Sussmann ,
Julio Garzon Agudelo ,
Catherine Rojas ,
Laline Osorio ,
Claudia Linares  and
Alberto Valderrama
...Show all authors
Carlos Álvarez Moreno
Affiliation:
Simon Bolivar Hospital, Bogata, Colombia San Ignacio Hospital, Pontificia Javeriana University, Bogata, Colombia
Victor D. Rosenthal
Affiliation:
Medical College of Buenos Aires, Argentina
Narda Olarte
Affiliation:
El Tunal ESE Hospital, Bogata, Colombia
Wilmer Villamil Gomez
Affiliation:
de la Sabana Medical Center, Sucre, Colombia Santa Maria Medical Center, Sucre, Colombia
Otto Sussmann
Affiliation:
La Nueva Medical Center, Bogata, Colombia Palermo Medical Center, Bogata, Colombia
Julio Garzon Agudelo
Affiliation:
Videlmédica Medical Center, Bogata, Colombia
Catherine Rojas
Affiliation:
del Olaya Medical Center, Bogata, Colombia
Laline Osorio
Affiliation:
Simon Bolivar Hospital, Bogata, Colombia
Claudia Linares
Affiliation:
San Ignacio Hospital, Pontificia Javeriana University, Bogata, Colombia
Alberto Valderrama
Affiliation:
El Tunal ESE Hospital, Bogata, Colombia
Patricia Garrido Mercado
Affiliation:
de la Sabana Medical Center, Sucre, Colombia
Patrick Hernán Arrieta Bernate
Affiliation:
de la Sabana Medical Center, Sucre, Colombia
Guillermo Ruiz Vergara
Affiliation:
Santa Maria Medical Center, Sucre, Colombia
Alberto Marrugo Pertuz
Affiliation:
Santa Maria Medical Center, Sucre, Colombia
Beatriz Eugenia Mojica
Affiliation:
La Nueva Medical Center, Bogata, Colombia
María del Pilar Torres Navarrete
Affiliation:
Palermo Medical Center, Bogata, Colombia
Ana Sofia Alonso Romero
Affiliation:
Department of Infection Control and Epidemiology, Bogota, Colombia
Daibeth Henríquez
Affiliation:
Department of Infection Control and Epidemiology, Bogota, Colombia
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Abstract

Objective.

To perform active targeted prospective surveillance to measure device-associated infection (DAI) rates, attributable mortality due to DAI, and the microbiological and antibiotic resistance profiles of infecting pathogens at 10 intensive care units (ICUs) in 9 hospitals in Colombia, all of which are members of the International Infection Control Consortium.

Methods.

We conducted prospective surveillance of healthcare-associated infection in 9 hospitals by using the definitions of the US Centers for Disease Control and Prevention National Nosocomial Surveillance System (NNIS). DAI rates were calculated as the number of infections per 100 ICU patients and per 1,000 device-days.

Results.

During the 3-year study, 2,172 patients hospitalized in an ICU for an aggregate duration of 14,603 days acquired 266 DAIs, for an overall DAI rate of 12.2%, or 18.2 DAIs per 1,000 patient-days. Central venous catheter (CVC)–related bloodstream infection (BSI) (47.4% of DAIs; 11.3 cases per 1,000 catheter-days) was the most common DAI, followed by ventilator-associated pneumonia (VAP) (32.3% of DAIs; 10.0 cases per 1,000 ventilator-days) and catheter-associated urinary tract infection (CAUTI) (20.3% of DAIs; 4.3 cases per 1,000 catheter-days). Overall, 65.4% of all Staphylococcus aureus infections were caused by methicillin-resistant strains; 40.0% of Enterobacteriaceae isolates were resistant to ceftriaxone and 28.3% were resistant to ceftazidime; and 40.0% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones, 50.0% were resistant to ceftazidime, 33.3% were resistant to piperacillin-tazobactam, and 19.0% were resistant to imipenem. The crude unadjusted attributable mortality was 16.9% among patients with VAP (relative risk [RR], 1.93; 95% confidence interval [CI], 1.24-3.00; P = .002); 18.5 among those with CVC-associated BSI (RR, 2.02; 95% CI, 1.42-2.87; P<.001); and 10.5% among those with CAUTI (RR, 1.58; 95% CI, 0.78-3.18; P = .19).

Conclusion.

The rates of DAI in the Colombian ICUs were lower than those published in some reports from other Latin American countries and were higher than those reported in US ICUs by the NNIS. These data show the need for more-effective infection control interventions in Colombia.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 4 , April 2006 , pp. 349 - 356
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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