Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador

Posted on May 20, 2017 • Filed under: Ecuador, Ecuador Emergency, Latin America Health

ECUADOR MEDICAL STUDY IN INTENSIVE CARE UNITS / wjbc/ Device-associated healthcare-acquired infections (DA-HAIs) are one of the main threats to the safety of patients, causing patient morbidity, mortality, excess costs and prolonged length of hospital stay (LOS), particularly in intensive care settings of limited-resource countries[1-3].

To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador.

A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods.


Core tip: This is a prospective, cohort, surveillance study on device-associated infection rates, mortality, length of stay and bacterial resistance conducted in intensive care units (ICUs) in Ecuador from October 2013 to January 2015. Device-associated healthcare-acquired infection rates in our ICUs from Ecuador are significantly higher than United States Centers for Disease Control and Prevention’s National Healthcare Safety Network’s rates and similar to International Nosocomial Infection Control Consortium’s international rates……….

Different factors can elucidate the possible reasons for these higher DA-HAI rates compared with the United States CDC’s NHSN and INICC’s reports. As also occurs in other developing countries, we consider that adherence to infection control bundles in Ecuador is variable, there is frequently a low nurse-patient staffing ratio (with a nurse-patient ratio higher than 4:1) and the number of experienced nurses or trained healthcare workers is deficient – which has been demonstrated as significantly associated with considerably high DA-HAI incidence rates in the ICU patient[31]. In addition, there is hospital over-crowding. According to World Health Organization standards[32], there should be between 8 and 10 hospital beds available per 1000 persons, but in 2011, in Ecuador, there were only 1.5 per 1000, with many hospitals remaining at full capacity[33].

The risk of infection of patients hospitalized in ICUs can be reduced though the implementation of surveillance targeted on DA-HAI, because it is successful to focus on characteristics of the burden of DA-HAIs. These surveillance data is necessary to increase ICPS’s sensitivity and aids them to detecting HAIs and avoiding underreporting[5].


The findings of this study highlight that DA-HAIs pose major challenges for public health and the wellbeing of patients in Ecuador. One of INICC’s primary goals is to provide health care facilities worldwide with free tools and resources to support the introduction of systematic infection prevention practices in order to address this burden effectively by accomplishing a reduction in DA-HAI rates and their adverse effects. READ FULL ARTICLE

Estuardo Salgado Yepez, Maria M Bovera, Victor D Rosenthal, Hugo A González Flores, Leonardo Pazmiño, Francisco Valencia, Nelly Alquinga, Vanessa Ramirez, Edgar Jara, Miguel Lascano, Veronica Delgado, Cristian Cevallos, Gasdali Santacruz, Cristian Pelaéz, Celso Zaruma, and Diego Barahona Pinto

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