Main Menu Browse by Day or Program Author Keywords

828 HEALTHCARE ASSOCIATED INFECTION SURVEILLANCE SYSTEM IN SAO PAULO STATE, BRAZIL: FIRST FIVE YEAR RESULTS

Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Denise B. Assis, MD, MPH , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Geraldine Madalosso, MD, MPH , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Silvia A. Ferreira, RN , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Yara Y. Yassuda, DD, MPH , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Ana L. Geremias, Biologist, MPH , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Maria G. Valente, MD , Infection Control Division/Surveillance Center/Sao Paulo State Health Department, Sao Paulo, Brazil
Maristela P. Freire, MD, MSc , Surveillance Center/Sao Paulo State Health Department/Hospital of clinics, University of Sao Paulo, Sao Paulo, Brazil
Carlos M. C. B. Fortaleza, MD, MSc, PhD , Surveillance Center/Sao Paulo State Health Department/Medicine School of Botucatu, State University of Sao Paulo-UNESP, Sao Paulo, Brazil
Maria Clara Padoveze, RN, MD, PhD , Escola de Enfermagem, Universidade de Sao Paulo, Sao Paulo, Brazil

Background: Governmental programs should be developed to promote a network of data of Hospital Associated Infections (HAI).

Objective: This study describes the first five year results of the Surveillance System of the HAI in the São Paulo State, Brazil, and its implementation since 2004 to 2008.

Methods: The system had implemented components for Acute Care Hospitals (ACH) and Long Term Care Facilities (LTCF). The components for surveillance in ACH were: Surgical Unit, Intensive Care Unit (ICU), and High Risk Nursery. The infections under surveillance were: surgical site infection (SSI) in clean surgeries, pneumonia, urinary tract infection (UTI) and bloodstream infections (BSI) device-associated and susceptibility data for select organisms in BSI. For the LTCF component were reported pneumonia, scabies and gastroenteritis in all inpatients. The hospitals were trained to use standard definitions. The number of infections per 1,000 device-days or resident-days and SSI rates were calculate and distributed in percentiles, as proposed by the NNIS system, and a annual summary report is available on line. The number and percentage of microorganisms isolated in blood cultures are also reported in ICU.

Results: The increasing tendency of the number of hospitals reporting to the Surveillance System has been maintained. In the first year there were 457 participating healthcare settings, which represented 51.1% of the hospitals registered in the state database. Adherence to Surveillance System is increasing with a 46% in the number of hospitals reporting data between 2004 and 2008, with 669 hospitals in 2008 which represents a greater number of reporting hospitals when compared to other surveillance systems in the world. Median rates (percentile 50%) of device-related infections reported for ICU is presented in the graphic attached.

Conclusions: HAI Surveillance System in São Paulo State is a totally new governing surveillance system in Brazil. The results showed that it's feasible to collect data from a large number of hospitals. This tendency ensues the collection of consistent data allowing comparison among the hospitals and the direction of preventive actions for the control of HAI. This will provide Sao Paulo State Health Department an estimative of the HAI magnitude, an improvement of infection control and prevention programs, and an assessment of the impact of interventions and in resources allocation.