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Carga de la infección endémica asociada al cuidado de la salud en los países en desarrollo: revisión sistemática y
Benedetta Allegranzi1, Sepideh Bagheri Nejad, Christophe Combescure
1First Global Patient Safety Challenge, WHO Patient Safety, Geneva, Switzerland.
Lancet (London, England)
|December 15, 2010
Resumen
Las infecciones asociadas al cuidado de la salud son un problema frecuente en los países en desarrollo, con una prevalencia más alta que en Europa o los Estados Unidos. La mejora del control y la vigilancia de la infección es crucial.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- Las infecciones asociadas al cuidado de la salud (IAS) son un desafío global significativo, que afecta principalmente a la seguridad del paciente.
- Los datos sobre la epidemiología de las IHA en los países en desarrollo son escasos, lo que dificulta las intervenciones específicas.
- La Organización Mundial de la Salud pone de relieve la necesidad de una mejor comprensión de la carga de HAI en entornos de recursos limitados.
Objetivo del estudio:
- Evaluar sistemáticamente la epidemiología de las infecciones endémicas asociadas al cuidado de la salud en los países en desarrollo.
- Determinar la prevalencia, incidencia y causas microbiológicas de las IHA en estas regiones.
- Para comparar las tasas de HAI en los países en desarrollo con las reportadas en las naciones desarrolladas.
Principales métodos:
- Se realizó una búsqueda exhaustiva de la literatura a través de bases de datos electrónicas y listas de referencia para los estudios publicados entre 1995 y 2008.
- Se seleccionaron los estudios que proporcionan datos sobre la prevalencia o incidencia de HAI, incluidos sitios específicos de infección y agentes causantes, de países en desarrollo.
- Se evaluó la calidad del estudio y se agruparon los datos para su análisis, con un enfoque en estudios de alta calidad.
Principales resultados:
- Se incluyeron un total de 220 estudios, revelando una representación limitada de datos de muchos países en desarrollo, con el 54% clasificado como de baja calidad.
- Los estudios de alta calidad indicaron una prevalencia significativamente mayor de las IAC (15,5%) en comparación con Europa y los EE.UU..
- Las unidades de cuidados intensivos para adultos informaron densidades de HAI (47,9 por cada 1000 días-paciente) al menos tres veces más altas que en los EE.UU., siendo las infecciones en el sitio quirúrgico la infección más común adquirida en el hospital.
Conclusiones:
- Los países en desarrollo se enfrentan a una carga sustancial de infecciones asociadas a la atención médica.
- Existe una necesidad urgente de mejorar los sistemas de vigilancia e implementar prácticas sólidas de control de infecciones en estas regiones.
- Los hallazgos subrayan la brecha crítica en los datos y la necesidad de mejorar los estándares de atención médica para mitigar los riesgos de HAI.
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