Overview of the actions to combat bacterial resistance in large hospitals

Mariana Sanches De Mello,Adriana Cristina Oliveira

doi:10.1590/1518-8345.3952.3407

Mariana Sanches De Mello, Adriana Cristina Oliveira

Open Access

https://doi.org/10.1590/1518-8345.3952.3407

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Abstract

Objective:to analyze, in the clinical practice of large hospitals, how the adoption of measures to prevent and control the spread of bacterial resistance has occurred, and to propose a score for the institutions’ adherence.Method:a cross-sectional study carried out in 30 large hospitals of Minas Gerais, from February 2018 to April 2019, after approval by the Ethics and Research Committee. Interviews were conducted with hospital managers, with Hospital Infection Control Services coordinators, and with the care coordinators of the Inpatient Units and Intensive Care Center. In addition, observations were made of the adoption of preventive measures by the multidisciplinary team in the care units.Results:in the 30 participating hospitals, 93.3% (N=28) had protocols for prophylactic antibiotics, and 86.7% (N=26) performed their audit, 86.7% (N=26) for therapeutic antibiotics and 83.3% (N=25) their audit; 93.3% (N=56) used gloves and cloaks for patients in contact precautions, and 78.3% (N=47) of the professionals were unaware of or answered incompletely on the five moments for hand hygiene. In the score to identify the adoption of measures to control bacterial resistance, 83.3% (N=25) of the hospitals were classified as partially compliant, 13.3% (N=04) as deficient, and 3.4% (N=01) as non-adoption.Conclusion:it was found that the recommended measures to contain bacterial resistance are not consolidated in the clinical practice of the hospitals.

Highlights

Health care-related infections (HAIs) are defined by the National Healthcare Safety Network (NHSN) as systemic or localized conditions resulting from the action of infectious agents or their toxins, and can manifest themselves after 72 hours of admission or after the patient›s discharge(1)
The accredited hospitals accounted for 36.7% (N=11) of the sample
When analyzing the measures that constituted the score, it was evidenced that most of the hospitals participating in the study partially adopted the measures for the prevention and control of bacterial resistance

Summary

Introduction

Health care-related infections (HAIs) are defined by the National Healthcare Safety Network (NHSN) as systemic or localized conditions resulting from the action of infectious agents or their toxins, and can manifest themselves after 72 hours of admission or after the patient›s discharge(1). It is estimated that 70% of the HAIs are associated with antibiotic-resistant bacteria as the causative agent(2). Bacterial resistance has direct implications for patient safety. It prolongs their stay in the hospital, increases the chances of hospital readmission, the use of extended-spectrum antibiotics and the risk of death, mainly due to the absence of therapeutic alternatives(3-7). According to the author’s projection, starting in 2050, bacterial resistance will be responsible for the death of nearly ten million patients each year, surpassing the current number of deaths from cancer and other diseases(8). A high percentage of potentially lost years of life was estimated due to infections related to resistant bacteria in the European Union, reinforcing the issue as a worldwide public health problem(9)

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