One-day point prevalence of healthcare-associated infections and antimicrobial use in four countries in Latin America

Abstract

Background and aims: Experience in the region shows that in some countries there is very good surveillance of Healthcare-associated infections (HAIs) in health services, but there is no national data consistently in all countries. Therefore, we set to estimate the total burden of HAIs and antimicrobial use in acute care hospitals in Brazil, Venezuela, Mexico, and Colombia using the one-day point prevalence methodology. Methods: The survey was conducted between June and July 2016. In each ward or unit, HAIs and antimicrobial use data were collected on a single day by a trained team of researchers. Also, for each patient, we collected data on risk factors for infections. Results: One out of ten individuals surveyed had at least one healthcare-associated infection (HAI). Pneumonia and surgical site infections were the most relevant among the surveyed countries. Most of the surveyed participants, regardless of their HAI status, received antibiotics except the individuals managed in Brazil. Carbapenems and third-generation Cephalosporins were among the most frequently used antibiotics. Conclusion: Our results add to WHO's recent efforts to understand HAIs prevalence and antibiotic consumption in low and middle-income countries, of which we studied three that were not included in their last report.

Prevalence of healthcare-associated infections and antimicrobial use among inpatients in a tertiary hospital in Fiji: a point prevalence survey

“…Six out of every 10 patients at CWMH were receiving at least one antimicrobial on the day of the PPS. This is similar to surveys in other LMICs reporting rates between 49 and 70% [ 22 , 33 , 34 ], however much higher than rates of 33–34% reported in Japan, China, Europe and an international survey [ 20 , 35 – 37 ]. Carbapenem use at Fiji’s largest hospital was extremely low, with only one prescription recorded.…”

“…The HAI prevalence from our research in Fiji is similar or slightly lower than estimates from other studies in LMICs which also used ECDC criteria, such as 8.2% in Ghana, 8.4% in Pakistan, 13.5% in Botswana and 11.5% across four Latin American countries [21][22][23]. Compared to high-income settings, Fiji's HAI prevalence is higher than that reported in the USA (3.2%), Europe (6.5%), and Japan (7.4%) but lower than rates in Australia (9.9%) and Singapore (11.9%) [17][18][19][20]28].…”

“…SSIs were the most frequent HAI in our study, causing over one-third of all HAIs. The problem of SSIs in LMICs has been noted in multiple previous HAI studies, where they were ranked either first or second [21][22][23][24]32]. By contrast, SSIs routinely rank third or lower among HAIs in high-income settings, with the exception of Australia [19].…”

“…With neonatal ICU patients excluded, the HAI prevalence among children in our study was only 4.4% (3/69). Other recent PPSs from LMICs also include similarly high proportions of paediatric (from 15 to 26%) [21][22][23][24] and obstetric (from 19 to 30%) [21,23] patients, whereas recent studies from high-income countries showing higher HAI prevalence excluded paediatric patients [18,19]. Third, inpatients in Fiji may not have been as sick as those in other studies, although no comorbidity data was collected to allow direct comparison.…”

“…One of the most commonly used standardised PPS protocols to assess HAIs and AMU was developed by the European Centre for Disease Prevention and Control (ECDC) [15]. Although originally designed for use in the predominantly high-income setting of Europe [16,17], it has subsequently been employed by many other countries globally [18][19][20], including within low-and middleincome country (LMIC) settings [21][22][23][24].…”