Analysis of Healthcare-associated Infections before and during the COVID-19 pandemic in a Colombian hospital

Abstract

Highlights Gram-negative bacilli prevail in Healthcare-Associated Infections, revealing a microbial landscape shaped by COVID-19. Bacteremia emerges as a high-risk factor, especially impacting immunosuppressed or oncologic patients in our Colombian healthcare institution. Cephalosporin and carbapenem resistance pose a significant hurdle, emphasizing the evolving trends amidst the COVID-19 Impact on Healthcare Infections. Our study underscores the transformative impact of COVID-19 on healthcare infections, spotlighting emerging patterns and challenges in a high-complexity Colombian institution. Introduction: Healthcare-associated infections pose a significant challenge, contributing to hospital morbidity and mortality. Objective: To describe the behavior of Healthcare Associated Infections before and during the pandemic reported to a high-complexity health institution in Colombia. Material and Methods: 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. Results: 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. Discussion: The critical need for specific interventions and antimicrobial management to control HAIs, especially given the challenges posed by the COVID-19 pandemic, is highlighted. Conclusions: 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. How to cite this article: Wintaco Luz M, Quintero-Lesmes Doris C, Vargas-Soler José A, Barrera Diego M, Palacio Laura N, Granados Ulises, Uribe Luis G “Analysis Healthcare Infections before and during of COVID-19 pandemic in a Colombian hospital”. Revista Cuidarte. 2024;15(1):e3624.  http://dx.doi.org/10.15649/cuidarte.3624