1090. Electronic surveillance of Healthcare-Associated Infections (HAIs) and antimicrobial resistance in intensive care units (ICU) of CIDEIM´s Network in Colombia: a pilot study
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Electronic surveillance of Healthcare-Associated Infections (HAIs)_Colombia_IDWeek 2013.pdf (2.2 MB)
  • Background: In the last decades there has been an increase in the number of critically ill patients who require long term care; consequently, producing an increase in the risk of acquiring HAIs. HAIs are considered preventable, and surveillance systems (SS) have been proposed as means to reduce these events. In Colombia, SS are not standardized and a baseline has not been established. For this reason, a pilot study was created to assess the rates and the resistance mechanisms of HAI ICU isolates, through the implementation of an electronic SS. 

    Methods: A cross-disciplinary SS for the epidemiological and molecular characterization of HAIs was implemented between July and December 2012 in 19 adult and 6 pediatric ICUs from 10 hospitals in 9 cities. A novel electronic tool (HAI Solutions software ®) was developed to gather real time standardized clinical data allowing HAI definition based on CDC criteria. The pooled mean proportions of infections and device-related rates were calculated by type of location, HAI and overall. Isolates corresponding to cases of Ventilator-Associated Pneumonia (VAP), Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) were analyzed at CIDEIM´s lab. Phenotype was confirmed using Vitek2 and broth microdilution. Multiplex PCR was performed to detect ESBLs genes. 

    Results: Overall, the predominant HAI was VAP with 82 cases followed by CLABSI (67) and CAUTI (51). By type of location, the VAP rate was highest in medical/surgical major teaching ICUs (7.29 x 1000 ventilator-days), CLABSI was highest in medical-major teaching ICUs (4.11 x 1000 central line-days) and CAUTI was highest in pediatric medical/surgical ICUs (3.16 x 1000 urinary catheter-days). The most prevalent pathogen was K. pneumoniae with 26 isolates, of which 11 (42%) were ESBL positive. CTX-M was the most frequent ESBL.

    Conclusion: The implementation of an electronic-based SS for HAIs has allowed an effective and accurate collection of epidemiological data, and its integration with the molecular characterization of infecting pathogens. This strategy will allow the identification of a national base line, which will serve as reference to create guidelines in order to attempt to control the threat of HAI.

    Marta Vallejo, MD1, Cristhian Hernandez, Bsc2, Gabriel Motoa, MD2, Elsa De la Cadena, BS2, Adriana Correa, MSc2, Diana Cuesta, MD, PhD1, Victor M Blanco, MD2, John Quinn, MD3 and Maria V. Villegas, MD, MSc2, (1)Universidad Pontificia Bolivariana, Medellin, Colombia, (2)Centro Internacional De Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia, (3)AstraZeneca, Waltham, MA

    Disclosures:

    M. Vallejo, AstraZeneca: Speaker's Bureau, Speaker honorarium
    Abbott: Speaker's Bureau, Speaker honorarium
    Pfizer: Speaker's Bureau, Speaker honorarium
    Merck Sharp and Dohme: Speaker's Bureau, Speaker honorarium
    Biomerieaux: Speaker's Bureau, Speaker honorarium

    C. Hernandez, None

    G. Motoa, None

    E. De la Cadena, None

    A. Correa, None

    D. Cuesta, None

    V. M. Blanco, None

    J. Quinn, AstraZeneca: Employee, Salary

    M. V. Villegas, MSD: Consultant, Research support
    AstraZeneca: Consultant, Research support
    Pfizer: Consultant, Research support
    Merck SA Colombia: Consultant, Research support
    Novartis: Consultant, Research support

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.