Public policies on healthcare-associated infections: a Brazil and UK case study

Padoveze, Maria Clara; Melo, Sara Moutinho Barbosa de; Bishop, Simon; Poveda, Vanessa de Brito; Fortaleza, Carlos Magno Castelo Branco

doi:10.11606/s1518-8787.2017051000315

Cited by 7 publications

(10 citation statements)

References 20 publications

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“…Although Brazil has made considerable progress regarding healthcare prevention programs in the last two decades, structure fragilities remain (7) . Government systems of epidemiological surveillance have been introduced, but they still need to be improved (8) . According to data from the latest prevalence study conducted in Brazil, roughly 1 out of every 10 patients admitted to hospital will be affected by HAIs (9) .…”

Section: Characteristics Of Healthcare-associated Infectionsmentioning

confidence: 99%

The concept of vulnerability applied to Healthcare-associated Infections

et al. 2019

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Objective: To discuss the potentialities of using the concept of vulnerability to support measures for preventing and controlling healthcare-associated infections (HAIs). Methods: This theoretical study was conducted in steps: 1) presentation of markers that frame the concept of vulnerability; 2) presentation of the characteristics of the health events to which the concept of vulnerability is intended to be applied; 3) identification of research gaps that could be potentially filled by using the concept of vulnerability; 4) identification of the potentialities of using the concept of vulnerability to deal with HAIs. Results: Proposal of a framework for analyzing HAIs from a vulnerability perspective, including the individual and collective dimensions. Conclusion: Using the concept of vulnerability to study and deal with HAIs favors a new approach to an old problem, unlike the dominant studies that highlight the individual aspects of the practices in healthcare services.

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Section: Characteristics Of Healthcare-associated Infectionsmentioning

confidence: 99%

The concept of vulnerability applied to Healthcare-associated Infections

et al. 2019

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“…Healthcare-associated infections (HAI) are a public policy concern in low-and middle-income countries, particularly in terms of providing technological support and qualified human resources, as well as improving antimicrobial stewardship programs and reducing the rates of microbial resistance [1]. Studies have shown that, in Brazil, the prevalence of HAIs in hospitals is 10.8% and pneumonia is the most common HAI [2].…”

Section: Introductionmentioning

confidence: 99%

Polymyxin for treatment of ventilator-associated pneumonia in a setting of high carbapenem resistance

et al. 2020

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Objectives To analyse the use of polymyxins for the treatment of ventilator-associated pneumonia (VAP) at a teaching hospital where carbapenem-resistant gram-negative bacteria are endemic. Patients and methods This was a historical cohort study of patients receiving polymyxins to treat VAP in ICUs at a public university hospital in southern Brazil between January 1, 2017 and January 31, 2018. Results During the study period, 179 cases of VAP were treated with polymyxins. Of the 179 patients, 158 (88.3%) were classified as having chronic critical illness. Death occurred in 145 cases (81.0%). Multivariate analysis showed that the factors independently associated with mortality were the presence of comorbidities (P<0.001) and the SOFA score of the day of polymyxin prescription (P<0.001). Being a burn patient was a protective factor for mortality (P<0.001). Analysis of the 14-day survival probability showed that mortality was higher among the patients who had sepsis or septic shock at the time of polymyxin prescription (P = 0.028 and P<0.001, respectively). Acinetobacter baumannii was identified as the etiological agent of VAP in 121 cases (67.6%). In our cohort, polymyxin consumption and the incidence density of VAP were quite high.

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“…7 In the years immediately prior (2003)(2004)(2005), the Brazilian Program of Infection Control was restructured, and some states started reporting surveillance data. 8 More information about HAIs was available than ever before, as the country underwent a period of economic development and political stability during this time. Finally, in those years, the first demands for public disclosure of individual hospitals' HAI rates were made by consumer protection organizations.…”

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confidence: 99%

Drivers of press media response to healthcare-associated infections caused by multidrug-resistant organisms: A report from Brazil

Carazatto

Calil

Fortaleza

2020

Infect. Control Hosp. Epidemiol.

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To the Editor-Public awareness of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) has been described both as a primary goal of prevention policies 1 and as a factor influencing the practice of healthcare epidemiology. 2 Furthermore, public awareness can increase advocacy and can achieve higher levels of political commitment, 3 which is important to the development of countrywide (and even worldwide) infection prevention and control programs. This factor is especially relevant for low-to-middle income countries, in which higher incidences of HAIs are found and most of which do not include infection control in their public health agendas. 4 Mass media (including printed and online press) has been variably successful in promoting changes in health behavior in issues such as tobacco use and protection against sexually transmitted infections. 5 Much less evidence is available regarding whether media can favorably influence public health policies, although the media may raise public awareness. 6 For HAIs and AMR, both impacts (on individual behavior and public policies) may play roles in prevention and control; however, the extent of their influence remains unclear. To assess this issue, we conducted a review of press media news regarding 2 multidrug-resistant organisms (MDROs) that are hyperendemic in Brazilian hospitals 7 : carbapenem-resistant Acinetobacter baumannii complex (CRAB) and carbapenemresistant Enterobacteriaceae (CRE). We chose to search the G1/ GLOBO (www.g1.globo.com), which is the largest digital media network in Brazil, with branches in all Brazilian states. The search period included 2006 through 2017. Because we were interested in a sensitive search, we used simple terms: Acinetobacter, Klebsiella, Enterobacter OR Escherichia coli OR Enterobacteria OR Enterobacteriaceae OR CRE OR KPC OR resistance to carbapenems. We used the following inclusion criteria: (1) description of single cases, case series, endemicity or outbreaks of CRAB or CRE in hospitals and (2) all cases and/or healthcare settings possible to be assigned to a specific Brazilian state or region. The number of articles was then analyzed considering national surveillance data. Because we were interested in the "exposure of readers" to the subject, we did not exclude articles with overlapped or partially duplicated information. However, complete duplications (reprints of the same article) were excluded.

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Public policies on healthcare-associated infections: a Brazil and UK case study

Cited by 7 publications

References 20 publications

The concept of vulnerability applied to Healthcare-associated Infections

The concept of vulnerability applied to Healthcare-associated Infections

Polymyxin for treatment of ventilator-associated pneumonia in a setting of high carbapenem resistance

Drivers of press media response to healthcare-associated infections caused by multidrug-resistant organisms: A report from Brazil

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