PMID- 16622811
OWN - NLM
STAT- MEDLINE
DCOM- 20060927
LR  - 20150127
IS  - 0899-823X (Print)
IS  - 0899-823X (Linking)
VI  - 27
IP  - 4
DP  - 2006 Apr
TI  - Device-associated infection rate and mortality in intensive care units of 9 
      Colombian hospitals: findings of the International Nosocomial Infection Control 
      Consortium.
PG  - 349-56
AB  - 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.
FAU - Moreno, Carlos Alvarez
AU  - Moreno CA
AD  - Simon Bolivar Hospital, Bogata, Columbia.
FAU - Rosenthal, Victor D
AU  - Rosenthal VD
FAU - Olarte, Narda
AU  - Olarte N
FAU - Gomez, Wilmer Villamil
AU  - Gomez WV
FAU - Sussmann, Otto
AU  - Sussmann O
FAU - Agudelo, Julio Garzon
AU  - Agudelo JG
FAU - Rojas, Catherine
AU  - Rojas C
FAU - Osorio, Laline
AU  - Osorio L
FAU - Linares, Claudia
AU  - Linares C
FAU - Valderrama, Alberto
AU  - Valderrama A
FAU - Mercado, Patricia Garrido
AU  - Mercado PG
FAU - Bernate, Patrick Hernan Arrieta
AU  - Bernate PH
FAU - Vergara, Guillermo Ruiz
AU  - Vergara GR
FAU - Pertuz, Alberto Marrugo
AU  - Pertuz AM
FAU - Mojica, Beatriz Eugenia
AU  - Mojica BE
FAU - Navarrete, Maria del Pilar Torres
AU  - Navarrete Mdel P
FAU - Romero, Ana Sofia Alonso
AU  - Romero AS
FAU - Henriquez, Daibeth
AU  - Henriquez D
LA  - eng
PT  - Journal Article
DEP - 20060329
PL  - United States
TA  - Infect Control Hosp Epidemiol
JT  - Infection control and hospital epidemiology
JID - 8804099
SB  - IM
MH  - Bacteremia/epidemiology/etiology
MH  - Catheterization, Central Venous/adverse effects
MH  - Catheters, Indwelling/microbiology
MH  - Colombia/epidemiology
MH  - Cross Infection/classification/*epidemiology/mortality
MH  - Drug Resistance, Bacterial
MH  - Equipment and Supplies/*adverse effects/microbiology
MH  - Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Intensive Care Units/standards/*statistics & numerical data
MH  - Pneumonia, Bacterial/epidemiology/etiology
MH  - Risk Assessment
MH  - *Sentinel Surveillance
MH  - Urinary Tract Infections/epidemiology/etiology
MH  - Ventilators, Mechanical/microbiology
EDAT- 2006/04/20 09:00
MHDA- 2006/09/28 09:00
CRDT- 2006/04/20 09:00
PHST- 2005/08/31 00:00 [received]
PHST- 2005/12/16 00:00 [accepted]
PHST- 2006/04/20 09:00 [pubmed]
PHST- 2006/09/28 09:00 [medline]
PHST- 2006/04/20 09:00 [entrez]
AID - ICHE2005281 [pii]
AID - 10.1086/503341 [doi]
PST - ppublish
SO  - Infect Control Hosp Epidemiol. 2006 Apr;27(4):349-56. doi: 10.1086/503341. Epub 
      2006 Mar 29.