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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

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April 2006

Volume 27, Number 4
Infect Control Hosp Epidemiol 2006;27:349–356
© 2006 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2006/2704-0005$15.00
DOI: 10.1086/503341
ORIGINAL ARTICLE

Device‐Associated Infection Rate and Mortality in Intensive Care Units of 9 Colombian Hospitals: Findings of the International Nosocomial Infection Control Consortium

Carlos Álvarez Moreno, MD;

Victor D. Rosenthal, MD;

Narda Olarte, MD;

Wilmer Villamil Gomez, MD;

Otto Sussmann, MD;

Julio Garzon Agudelo, MD;

Catherine Rojas, MD;

Laline Osorio, RN;

Claudia Linares, RN;

Alberto Valderrama, RN;

Patricia Garrido Mercado, MD;

Patrick Hernán Arrieta Bernate, MD;

Guillermo Ruiz Vergara, MD;

Alberto Marrugo Pertuz, MD;

Beatriz Eugenia Mojica, RN;

María del Pilar Torres Navarrete, RN;

Ana Sofia Alonso Romero, MD;

Daibeth Henríquez, MD

Dr. Moreno and Ms. Osorio are from Simon Bolivar Hospital, Bogata; Dr. Moreno and Ms. Linares are from San Ignacio Hospital, Pontificia Javeriana University, Bogata; Dr. Olarte and Mr. Valderrama are from El Tunal ESE Hospital, Bogata; Dr. Sussman and Ms. Mojica are from La Nueva Medical Center, Bogata; Dr. Sussman and Ms. Navarrete are from Palermo Medical Center, Bogata; Dr. Agudelo is from Videlmédica Medical Center, Bogata; Dr. Rojas is from del Olaya Medical Center, Bogata; and Drs. Romero and Henríquez are from the Department of Infection Control and Epidemiology, Bogota, Colombia. Dr. Rosenthal is from the Medical College of Buenos Aires, Argentina. Drs. Gomez, Mercado, and Bernate are from de la Sabana Medical Center, Sucre; and Drs. Gomez, Vergara, and Pertuz are from the Santa María Medical Center, Sucre, Colombia.

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; ); 18.5 among those with CVC‐associated BSI (RR, 2.02; 95% CI, 1.42‐2.87; ); and 10.5% among those with CAUTI (RR, 1.58; 95% CI, 0.78‐3.18; ).

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.

Received August 31, 2005; accepted December 16, 2005; electronically published March 29, 2006.

Address reprint requests to Victor D. Rosenthal, MD, Medical College of Buenos Aires, Arengreen 1366, Buenos Aires, 1405 Argentina ().

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H. Turgut, S. Sacar, D. Okke, S. T. Kavas, A. Asan, S. S. Kutlu. (2008) Evaluation of Device Associated Infection Rates in Intensive Care Units of Pamukkale University Hospital. Infection
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Jonas Marschall, MD; Carole Leone, RN; Marilyn Jones, RN; Deborah Nihill, RN; Victoria J. Fraser, MD; David K. Warren, MD, MPH. (2007) Catheter‐Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study •. Infection Control and Hospital Epidemiology 28:8, 905-909
Online publication date: 1-Aug-2007.
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