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Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium's findings

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World Journal of Biological Chemistry 2017年第1期8卷 95-101页

作者： Estuardo Salgado Yepez Maria M Bovera Victor D Rosenthal Hugo A González Flores leonardo pazmino Francisco Valencia Nelly Alquinga Vanessa Ramirez Edgar Jara Miguel Lascano Veronica Delgado Cristian Cevallos Gasdali Santacruz Cristian Pelaéz Celso Zaruma Diego Barahona Pinto Clínica la Merced Hospital de los Valles International Nosocomial Infection Control Consortium

AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, *** A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.

关键词： Ventilator-associated pneumonia Catheter-associated urinary tract infection Healthcare-associated infection Antibiotic resistance Developing countries Intensive care unit Surveillance Central line-associated bloodstream infections Hospital infection

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