Programa de detección y control de la infección y colonización de enterobacterias productoras de carbapenemasas en una Unidad de Cuidados Intensivos Pediátricos en Colombia

Introduction

Carbapenemase-producing Enterobacteriaceae (CPEs) are one of the multidrug-resistant microorganisms of greatest public health concern because they are a major cause of nosocomial infections, leading to higher costs, hospital stays, and increased mortality. This problem is increasingly frequent in the pediatric population with mortality rates due to associated infections of up to 50%. With this paper we would like to present and describe our experience in the implementation of a CLD detection and control program in our PICU.

Methods

A system of detection and screening through a search policy that defines the groups at risk and detects patients at risk of colonization by CLD, makes timely isolation of patients colonized with positive CLD and patients considered at risk of colonization pending the results of the culture, finally the control and monitoring of patients colonized by CLD.

Results

During the period from 2017 - 2020, 1548 patients were admitted to the PICU of the Hospital Universitario Fundación Santa Fe de Bogotá and it was determined that 6.1% of these met at least one risk factor for colonization by CLD; consequently, 95 screenings were performed in 4 years. At the end of the period studied, a cumulative incidence of CLD colonization of 18.94% was obtained among patients with risk factors.

Conclusions

We cannot analyze the factors associated with survival or find a significantly lower or higher survival rate by age; but at the end of follow-up we can affirm that this active surveillance strategy favors the rapid stratification of patient risk and the timely initiation of adequate antimicrobial therapy in early stages of infection. Also, timely and targeted treatment has been shown to improve clinical outcomes in high-risk patient populations, including patients with hematologic pathologies, and allows the development of personalized sepsis care plans.