2042. Impact of an Antimicrobial Stewardship Program on the Healthcare-Associated Infections in a Third-Level Hospital in Yucatán, México

Abstract

BackgroundAntimicrobial stewardship programs (ASPs) promote the responsible use of antimicrobials by limiting inappropriate use. This study evaluates the impact of a prospective ASP implementation on the health-care-associated infections (HCAIs) in a third-level hospital in Yucatán, México, after the establishment of an ASP in October 2017.MethodsThis was a prospective, single-center (Hospital de Alta de Especialidad de la Península de Yucatán -HRAEPY-), pre and post-intervention study, designed to analyze the impact of an ASP on health-care-associated infections rate, during January–October 2017 (pre-ASP) and January–October 2018 (post-ASP) by using comparative descriptive statistic of the monthly and annual rate of health-care-associated infections according to hospital network of epidemiological surveillance (RHOVE) in Mexico.ResultsDuring 2017, RHOVE reported 225 cases of HCAIs equivalent to a rate of 7.46/1,000 days of hospital stay. After ASP in 2018, the RHOVE reported 111 cases of HCAIs, equivalent to a rate of 4.38/1,000 days of hospital stay. This difference represented a reduction of −41.28% of the rate of HCAIs in the HRAEPY (Graphic 1). Antimicrobial susceptibility increased (pre-ASP vs. post-ASP) for 3 Gram-negatives associated with HCAIs at HRAEPY: TMP/SMX for E. coli (49% to 62%), Ciprofloxacino for K. pneumoniae (42% to 51%) and Piperacillin/Tazobactam (62% to 93%); Meropenem (61% to 72%) and Ciprofloxacino (67% to 79%) for P. aeruginosa (Graphic 2).ConclusionASP contributed to reducing the rate of HCAIs in the HRAEPY when it was implemented as an additional measure to the strategies for control of nosocomial infections. Additionally, this ASP caused an increase in the bacterial susceptibility of the most important microorganisms as a cause of infections associated with healthcare in HRAEPY. Disclosures All authors: No reported disclosures.