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

• 作者: Celso Zaruma Cristian Cevallos Cristian Pelaéz Diego Barahona Pinto Edgar Jara Estuardo Salgado Yepez Francisco Valencia Gasdali Santacruz Hugo A González Flores Leonardo Pazmi?o Maria M Bovera Miguel Lascano Nelly Alquinga Vanessa Ramirez Veronica Delgado Victor D Rosenthal
• 来源期刊: 世界生物化学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 联系通风机的肺病 联系导管的尿道感染 联系保健的感染 抗菌素抵抗 发展中的国家 特别护理联合起来 监视 中央联系线的血液感染 医院感染
• 年，卷（期）: 2017,（1）
• 页码范围: 95-101
• 页数: 7页
• 分类号: R197.323

摘要

AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS 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.