C Magno Castelo Branco Fortaleza1, M C Padoveze2, C R Veiga Kiffer3, A L Barth4, Irna C do Rosário Souza Carneiro5, H I Garcia Giamberardino6, J L Nobre Rodrigues7, L Santos Filho8, M J Gonçalves de Mello9, M Severino Pereira10, P Pinto Gontijo Filho11, M Rocha12, E A Servolo de Medeiros3, A C Campos Pignatari3. 1. Faculdade de Medicina de Botucatu, Botucatu, São Paulo State, Brazil. Electronic address: cmfortaleza@uol.com.br. 2. Escola de Enfermagem (School of Nursing), Universidade de São Paulo (USP), City of São Paulo, São Paulo State, Brazil. 3. Escola Paulista de Medicina (São Paulo School of Medicine), Universidade Federal de São Paulo (UNIFESP), City of São Paulo, São Paulo State, Brazil. 4. Universidade Federal do Rio Grande do Sul (UFRGS), City of Porto Alegre, State of Rio Grande do Sul, Brazil. 5. Universidade Federal do Pará (UFPA), City of Belém, Pará State, Brazil. 6. Hospital Pequeno Príncipe (HPP), City of Curitiba, State of Paraná, Brazil. 7. Universidade Federal do Ceará, City of Fortaleza, State of Ceará, Brazil. 8. Universidade Federal da Paraíba (UFPB), City of João Pessoa, State of Paraíba, Brazil. 9. Instituto Medicina Integral Prof. Fernando Figueira (IMIP), City of Recife, State of Pernambuco, Brazil. 10. Pontifícia Universidade Católica (PUC) - Goiás, City of Goiânia, State of Goiás, Brazil. 11. Universidade Federal de Uberlândia (UFU), City of Uberlândia, State of Minas Gerais, Brazil. 12. Fundação Instituto Oswaldo Cruz (FiOCruz), City of Rio de Janeiro, Rio de Janeiro State, Brazil.
Abstract
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds). Settings were randomly selected from a governmental database, except for 11 reference university hospitals. All patients with >48 h of admission to the study hospitals at the time of the survey were included. Trained epidemiologist nurses visited each hospital and collected data on HCAIs, subjects' demographics, and invasive procedures. Univariate and multivariate techniques were used for data analysis. FINDINGS: The overall HCAI prevalence was 10.8%. Most frequent infection sites were pneumonia (3.6%) and bloodstream infections (2.8%). Surgical site infections were found in 1.5% of the whole sample, but in 9.8% of subjects who underwent surgical procedures. The overall prevalence was greater for reference (12.6%) and large hospitals (13.5%), whereas medium- and small-sized hospitals presented rates of 7.7% and 5.5%, respectively. Only minor differences were noticed among hospitals from different macro-regions. Patients in intensive care units, using invasive devices or at extremes of age were at greater risk for HCAIs. CONCLUSION: Prevalence rates were high in all geographic regions and hospital sizes. HCAIs must be a priority in the public health agenda of developing countries.
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds). Settings were randomly selected from a governmental database, except for 11 reference university hospitals. All patients with >48 h of admission to the study hospitals at the time of the survey were included. Trained epidemiologist nurses visited each hospital and collected data on HCAIs, subjects' demographics, and invasive procedures. Univariate and multivariate techniques were used for data analysis. FINDINGS: The overall HCAI prevalence was 10.8%. Most frequent infection sites were pneumonia (3.6%) and bloodstream infections (2.8%). Surgical site infections were found in 1.5% of the whole sample, but in 9.8% of subjects who underwent surgical procedures. The overall prevalence was greater for reference (12.6%) and large hospitals (13.5%), whereas medium- and small-sized hospitals presented rates of 7.7% and 5.5%, respectively. Only minor differences were noticed among hospitals from different macro-regions. Patients in intensive care units, using invasive devices or at extremes of age were at greater risk for HCAIs. CONCLUSION: Prevalence rates were high in all geographic regions and hospital sizes. HCAIs must be a priority in the public health agenda of developing countries.
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