Luz M. Wintaco, D. C. Quintero-Lesmes, J. A. Vargas-Soler, Diego M. Barrera, Laura N. Palacio, Ulises Granados, Luis G. Uribe
{"title":"哥伦比亚一家医院在 COVID-19 大流行之前和期间的医护相关感染分析","authors":"Luz M. Wintaco, D. C. Quintero-Lesmes, J. A. Vargas-Soler, Diego M. Barrera, Laura N. Palacio, Ulises Granados, Luis G. Uribe","doi":"10.15649/cuidarte.3624","DOIUrl":null,"url":null,"abstract":"Highlights\n\nGram-negative bacilli prevail in Healthcare-Associated Infections, revealing a microbial landscape shaped by COVID-19.\nBacteremia emerges as a high-risk factor, especially impacting immunosuppressed or oncologic patients in our Colombian healthcare institution.\nCephalosporin and carbapenem resistance pose a significant hurdle, emphasizing the evolving trends amidst the COVID-19 Impact on Healthcare Infections.\nOur study underscores the transformative impact of COVID-19 on healthcare infections, spotlighting emerging patterns and challenges in a high-complexity Colombian institution.\n\nIntroduction: 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.\nHow 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","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of Healthcare-associated Infections before and during the COVID-19 pandemic in a Colombian hospital\",\"authors\":\"Luz M. Wintaco, D. C. Quintero-Lesmes, J. A. Vargas-Soler, Diego M. Barrera, Laura N. Palacio, Ulises Granados, Luis G. Uribe\",\"doi\":\"10.15649/cuidarte.3624\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Highlights\\n\\nGram-negative bacilli prevail in Healthcare-Associated Infections, revealing a microbial landscape shaped by COVID-19.\\nBacteremia emerges as a high-risk factor, especially impacting immunosuppressed or oncologic patients in our Colombian healthcare institution.\\nCephalosporin and carbapenem resistance pose a significant hurdle, emphasizing the evolving trends amidst the COVID-19 Impact on Healthcare Infections.\\nOur study underscores the transformative impact of COVID-19 on healthcare infections, spotlighting emerging patterns and challenges in a high-complexity Colombian institution.\\n\\nIntroduction: 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.\\nHow 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”. 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引用次数: 0
摘要
亮点格兰氏阴性杆菌在医疗相关感染中占主导地位,揭示了 COVID-19 所塑造的微生物景观。菌血症成为高危因素,尤其影响到哥伦比亚医疗机构中的免疫抑制或肿瘤患者。头孢菌素和碳青霉烯耐药性是一个重大障碍,凸显了 COVID-19 对医疗感染的影响中不断演变的趋势。我们的研究强调了 COVID-19 对医疗感染的变革性影响,突出了哥伦比亚一家高度复杂机构中新出现的模式和挑战:医疗相关感染是一项重大挑战,导致了医院的发病率和死亡率。目的:描述医疗相关感染的行为:描述哥伦比亚一家高度复杂的医疗机构在大流行之前和期间报告的医疗相关感染行为。材料与方法:在我们的医疗相关感染(HAIs)回顾性观察研究中,我们分析了 2018 年至 2020 年期间所有确诊为 HAIs 的住院患者的数据。其中包括从非社会性感染委员会前瞻性数据库中收集的临床、人口统计学、微生物学和微生物药敏信息。使用用于抗菌药耐药性监测的 Whonet 软件获得了 391 个分离物的数据。结果:我们发现了 504 例 HAIs(2018-2020 年),总体院内感染率为 2.55/1000 个患者日。儿科患者的中位年龄为 5 岁,成人为 56 岁,男性占 57%。主要入院诊断为肿瘤疾病并发症(31%)。菌血症的 30 天死亡率为 13%,主要与导管有关(37%)。革兰氏阴性杆菌,主要是肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌,占 HAI 病例的 58%。讨论鉴于 COVID-19 大流行所带来的挑战,强调了采取特定干预措施和抗菌药物管理以控制 HAIs 的迫切需要。结论:这是哥伦比亚桑坦德省布卡拉曼加市一家三级医院首次报告 HAI 发病率。菌血症占主导地位;75% 的 HAIs 患者患有合并症。革兰氏阴性杆菌占多数;在2020年COVID-19大流行期间,重症监护病房呼吸道感染显著增加。对头孢菌素和碳青霉烯类抗生素的耐药性十分普遍:Wintaco Luz M, Quintero-Lesmes Doris C, Vargas-Soler José A, Barrera Diego M, Palacio Laura N, Granados Ulises, Uribe Luis G "哥伦比亚医院 COVID-19 大流行之前和期间的医疗感染分析"。Revista Cuidarte.2024;15(1):e3624. http://dx.doi.org/10.15649/cuidarte.3624
Analysis of Healthcare-associated Infections before and during the COVID-19 pandemic in a Colombian hospital
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