Surveillance of Healthcare-Associated Infections in Low- and Middle-Income Countries: From the Need to a Reality
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Surveillance of healthcare-associated infections (HAI) is a useful tool for prevention of HAI; however, in low- and middle-income countries, the implementation of HAI surveillance has many methodological and resources challenges. Some challenges are related to skilled and dedicated human resources to perform tasks; others are related to methodological issues such as HAI definition and diagnostic tests available, prioritization of infection to follow-up, data reporting methods, data quality and availability of analyzed information for decision-making. Lack of consistent and representative HAI data are hiding the real HAI problem and decreasing the chances to solve it. Countries should invest strongly to understand the real burden of HAI, and its costs in order to learn the best use of preventive measures available.
KeywordsSurveillance Hospital-acquired infection surveillance Healthcare-associated infection Infection prevention and control programs Infection prevention and control Core components for infection prevention and control
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Conflict of Interest
Dr. Stempliuk declares that she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
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- 1.•• Storr J, Twyman A, Zingg W, Damani N, Kilpatrick C, Reilly J. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. Antimicrobial Resistance & Infection Control. et al., 2017;6:6. https://doi.org/10.1186/s13756-016-0149-9. This article is a systemic literature review and experts consensus of Core Components of Infection Prevention and Control programme at local and national level recommendation and it includes surveillance as evidence based intervention for reduction of health care associated infection.
- 2.Haley RW, Culver DH, White JW, Morgan WM, Emori TG, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol. 1985;121(2):182–205. https://doi.org/10.1093/oxfordjournals.aje.a113990.CrossRefPubMedGoogle Scholar
- 5.Pacheco Licor VM, Gutiérrez Castañeda DC, Serradet GM. Vigilancia epidemiologica de infecciones asociadas a la asistencia sanitaria. Revista de Ciencias Medicas. 2014;18(3):430–40.Google Scholar
- 6.Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228–41. https://doi.org/10.1016/S0140-6736(10)61458-4.CrossRefPubMedGoogle Scholar
- 8.• Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank H-P, Ducomble T, et al. Burden of six healthcare-associated infections on European population health: estimating incidence based disability-adjusted life years through a population prevalence-based modelling study. PLoS Med. 2016;13(10):e1002150. This article describes a burden of healthcare associated infection in European countries and compares the estimations with the burden of other transmissible disease. The methodology used can be useful to make estimations of burden of HAI at country level. https://doi.org/10.1371/journal.pmed.1002150.CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Costa LB, Cardoso MR, Ferreira CG, Levy CE, Borba HM, et al. National prevalence survey in Brazil to evaluate the quality of microbiology laboratories: the importance of defining priorities to allocate limited resources. Rev Panam Salud Publica. 2013;33(1):73–8. https://doi.org/10.1590/S1020-49892013000100010.CrossRefPubMedGoogle Scholar
- 14.National Healthcare Safety Network (NHSN) Patient Safety Component Manual. Available at https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf
- 15.Informe de Vigilancia Epidemiologica de Infecciones Intrahospitalarias, Chile 2014 available at: http://web.minsal.cl/infecciones_intrahospitalarias/#VIGILANCIA EPIDEMIOLÓGICA.
- 16.Boletim de Segurança do Paciente e Qualidade em Serviços de Saúde n° 14: Avaliação dos indicadores nacionais das Infecções Relacionadas à Assistência à Saúde (IRAS) e Resistência microbiana do ano de 2015. Agência Nacional de Vigilância Sanitária. Brasil. Available at: file:///C:/Users/stempliv/Downloads/BOLETIM_SEGURANA_DO_PACIENTE_14.pdf.Google Scholar
- 17.Villalobos AP, Barrero LI, Rivera SM, Ovalle MV, Valera D. Vigilancia de infecciones asociadas a la atención en salud, resistencia bacteriana y consumo de antibióticos en hospitales de alta complejidad, Colombia, 2011. Biomedica. 2014;34(Supl.1):67–80. https://doi.org/10.7705/biomedica.v34i0.1698.PubMedGoogle Scholar
- 18.Rapid Evaluation Guide for Hospital Programs for Prevention and Control of Nosocomial Infections. PAHO 2011 Available at: http://www.paho.org/hq/index.php?option=com_topics&view=readall&cid=4130&Itemid=40930&lang=en
- 19.Acosta-Gnass S, Aragón JC, Benoit SR, Betancourt MI, Clara L, et al. Hospital infection in seven countries of Latin America. Rev Panam Infectol. 2008;10(4 Supl 1):S112–22.Google Scholar