Implications of Healthcare-Associated Infections in Health Management: Review
DOI:
https://doi.org/10.22235/ech.v11i1.2746Keywords:
hospital-acquired infections, health management, health care costsAbstract
Objective: Describe the scientific evidence of the implications Healthcare-Associated Infections (HAI) in health management. Method: Systematic review in electronic database using DeCs descriptors. Results: Thirteen articles were analyzed, resulting in ten categories of analysis. HAIs contribute to higher mortality rate and financial costs of hospitalization related to higher: average number of days of hospitalizations; increased spending on antimicrobials, diagnostic and complementary tests and invasive devices or procedures; length of hospital stay in intensive care units (ICU); possibility of readmission and development of other complications. Conclusions: HAIs have direct and indirect repercussions on patients’ lives as they represent a threat to the safety and quality of care. Prevention programs and infection control measures are considered effective in reducing the incidence rate of HAIs and consequently in reducing costs.
Downloads
References
Almeida G, Alves J, Mendes JJ, Perelman J, Lobão MJ, Sousa P. Infeções associadas a cuidados de saúde. Contributo da Indústria de meios de diagnóstico in vitro para o seu controlo. [Internet]. 2016 [cited 2022 feb 28]. Available from: https://www.researchgate.net/publication/320306445_IACS_Contributo_da_industria_de_meios_de_diagnostico_in_vitro_para_o_seu_controlo
European Centre for Disease Prevention and Control. Directory of online resources for prevention and control of antimicrobial resistance and healthcare-associated infections. [Internet]. 2021 [cited 2022 feb 28]. Available from: https://www.ecdc.europa.eu/en/publications-data/directory-online-resources-prevention-and-control-antimicrobial-resistance-amr.
World Health Organization. Prevention of hospital-acquired infections: a practical guide (2ª ed.). [Internet]. 2002 [cited 2021 mar 10]. Available from: https://apps.who.int/iris/handle/10665/67350
European Centre for Disease Prevention and Control. Realização, Desafios e principais resultados de 2016. [Internet]. 2017 [cited 2021 mar 10]. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Director2016_Citizen_PT.pdf
Centers for Disease Control and Prevention. Data Portal of Healthcare-Associated Infections. [Internet]. 2015 [cited 2022 mar 01]. Available from: https://www.cdc.gov/hai/data/portal/index.html.
Direção-Geral da Saúde. Infeções e Resistências aos Antimicrobianos: Relatório Anual do Programa Prioritário. [Internet]. 2018 [cited 2021 mar 12]. Available from: https://www.dgs.pt/documentos-e-publicacoes/infecoes-e-resistencias-aos-antimicrobianos-2018-relatorio-anual-do-programa-prioritario.aspx.
Observatório Português dos Sistemas de Saúde. Meio caminho andado. Relatório Primavera 2018. [Internet]. 2019 [cited 2021 mar 12]. Available from: http://opss.pt/relatorio-primavera/.
Scott RD, Culler SD, Rask KJ. Understanding the Economic Impact of Health Care-Associated Infections: A Cost Perspective Analysis. J Infusion Nurs. [Internet]. 2019 mar/apr [cited 2021 mar 13];42(2):61-69. Available from: https://pubmed.ncbi.nlm.nih.gov/30817421/ DOI: 10.1097/NAN.0000000000000313
Lorenzetti J, Lanzoni GM, Assuiti LF, Pires DE, Ramos, FR. Health management in Brazil: dialogue with public and private managers. Scielo Brazil [Internet]. 2014 [cited 2022 mar 01];23(02):417-425. Available from: https://www.scielo.br/j/tce/a/qJDNdkLvQ9qc6wVRsQRmyyH/?format=pdf&lang=pt DOI: 10.1590/0104-07072014000290013
Cardoso, RA. As infeções associadas aos cuidados de saúde. [Dissertação de Mestrado na Internet]. Coimbra (Portugal): Universidade de Coimbra, Faculdade de Economia; 2015 [cited 2022 mar 01].100 p. Available from: https://estudogeral.sib.uc.pt/bitstream/10316/29677/1/IACS%20final.pdf.
Barros, CS. Custos atribuídos às infeções de sitio cirúrgico em um hospital univeritário em Salvador-Bahia. [Tese Doutoramento na Internet]. Brasil: Fundação Oswaldo Cruz, Centro de Pesquisas Gonçalo Moniz; 2016 [cited 2022 mar 01]. 102 p. Available from: https://www.arca.fiocruz.br/bitstream/icict/14243/2/Claudia%20Silva%20Marinho%20Antunes%20Barros%20Custos...%202016.pdf
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. BMJ [Internet]. 2009 [cited 2019 jun];339, b2535. DOI: 10.1136/bmj.b2535
Saavedra CH, Ordóñez KM, Díaz JA. Impacto de la infección nosocomial en un hospital de Bogotá, Colombia: efectos en mortalidad y costos. Rev Chil Infectol [Internet]. 2015 feb [cited 2019 jun];32(1):25-9. DOI 10.4067/S0716-10182015000200004
Morales E, Cots F, Sala M, Comas M, Belvis F, Riu M, et al. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. BMC Health Serv Res. [Internet]. 2012 may [cited 2019 jun];12(122):1–8. DOI: 10.1186/1472-6963-12-122.
Nangino GO, Oliveira CD, Correia PC, Machado NM, Dias DA. Impacto financeiro das infecções nosocomiais em unidades de terapia intensiva em hospital filantrópico de Minas Gerais. Rev Bras Ter Intensiva [Internet]. 2012 dec [cited 2019 jun];24(4):357–61. DOI: 10.1590/S0103-507X2012000400011
Barrero LI, Castillo JS, Leal AL, Sánchez R, Cortés JA, Álvarez CA, et al. Impacto económico de la resistencia a la meticilina en pacientes con bacteriemia por Staphylococcus aureus en hospitales de Bogotá. Biomédica [Internet]. 2014 [cited 2019 jun];34:345–54. DOI: 10.7705/biomedica.v34i3.1692
Azmi S, Mohamed S, Maimaiti N, Ali A, Muhammad A, Rosas-valera MD, et al. Assessing the burden of pneumonia using administrative data from Malaysia, Indonesia, and jthe Philippines. Int J Infect Dis [Internet]. 2016 aug [cited 2019 Jun];49:87–93. DOI: 10.1016/j.ijid.2016.05.021
Izaias ÉM, Rossaneis MÂ, Belei RA. Custo e caracterização de infecção hospitalar em idosos. Ciência & Saúde Coletiva [Internet]. 2014 aug [cited 2019 jun];19(8):3395–402. DOI: 10.1590/1413-81232014198.12732013
Magalini S, Pepe G, Panunzi P, Spada A, Gaetano A, Gui D. An economic evaluation of Clostridium difficile infection management in an Italian hospital environment. Eur Rev Med Pharmacol Sci [Internet]. 2012 dec [cited 2019 jun];16:2136–41.
Resch A, Wilke M, Fink C. The cost of resistance : incremental cost of methicillin-resistant Staphylococcus aureus (MRSA) in German hospitals. Eur J Heal Econ [Internet]. 2009 jul [cited 2019 jun];10:287–97. DOI: 10.1007/s10198-008-0132-3
Ortiz-Mayorga J, Pineda-Rodríguez I, Dennis R, Porras A. Costos atribuidos a las infecciones asociadas a la atención en una Institución Prestadora de Salud de Colombia, 2011 a 2015 Attributed. Rev Biomédica (Instituto Nac Salud) [Internet]. 2019 jan/mar [cited 2019 jun]. DOI: 10.7705/biomedica.v39i1.4061
Kaye KS, Patel DA, Stephens JM, Khachatryan A. Rising United States Hospital Admissions for Acute Bacterial Skin and Skin Structure Infections : Recent Trends and Economic Impact. PLoS One [Internet]. 2015 nov 24 [cited 2019 jun];10(11):1–13. DOI: 10.1371/journal.pone.0143276
Greco G, Shi W, Michler RE, Meltzer DO, Ailawadi G, Hohmann SF, et al. Costs Associated With Health Care – Associated Infections in Cardiac Surgery. J Am Coll Cardiol [Internet]. 2015 jan 6 [cited 2019 jun];65(1):15–23. DOI: 10.1016/j.jacc.2014.09.079.
Cheah A, Spelman T, Liew D, Peel T, Howden BP, Spelman D, et al. Enterococcal bacteraemia : factors influencing mortality , length of stay and costs of hospitalization. Clin Microbiol Infect. European Society of Clinical Infectious Diseases [Internet]. 2013 apr [cited 2019 jun];19(4):181–9. DOI: 10.1111/1469-0691.12132
Jiang H, Zhou Z, Wang L, Fang Y, Li Y, Chu C. The Risk Factors, Costs, and Survival Analysis of Invasive VRE Infections at a Medical Center in Eastern Taiwan. Int J Infect Dis [Internet]. 2017 jan [cited 2019 jun];54:18–24. DOI: 10.1016/j.ijid.2016.11.005
Martins PC, Vaz AK. Infecções prevalentes na unidade de terapia intensiva de um hospital universitário. Enferm Bras [Internet]. 2020 [cited 2021 mar 19];19(3):238-45. DOI: 10.33233/eb.v19i3.3948
Coelho N, Cunha M. Padrão de Infeção e Antibioterapia em Unidade de Cuidados Intensivos. Millenium [Internet]. 2020 [cited 2021 mar 17];2:317-38. DOI: 10.29352/mill0205e.33.00339
Cassini A, Hogberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European economic area in 2015: a population-level modelling analysis. Lancet Infect Dis [Internet]. 2019 [cited 2021mar 17];19(1):56–66. DOI: 10.1016/S1473-3099(18)30605-4
Reis C. et al. A segurança do paciente como dimensão da qualidade do cuidado de saúde – um olhar sobre a literatura. Rio de Janeiro: Ciência e Saúde Coletiva [Internet]. 2013 jul [cited mar 17];18(7):2029-2036. DOI: 10.1590/S1413-81232013000700018
Pina E, Ferreira E, Marques A, Matos B. Infeções associadas aos cuidados de saúde e segurança do doente. Revista Portuguesa de Saúde Pública [Internet]. 2010 [cited 2019 aug 20];27-39.
O’Neil J. Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance [Internet]. 2016 may [cited 2021 mar 18];84p. Available from: https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf
Oh AL, Goh LM, Azim NA, Tee CS, Phung CW. Antibiotic usage in surgical prophylaxis: a prospective surveillance of surgical wards at a tertiary hospital in Malaysia. J Infect Dev Ctries [Internet]. 2014 feb [cited 2021 mar 27];8(2):193-201. DOI: 10.3855/jidc.3076
Direção-Geral da Saúde. Prevenção e Controlo de Infeções e de Resistência aos Antimicrobianos em Números – 2015 [Internet]. 2016 [cited 2021 mar 16]. Available from: http://www.arsalgarve.min-saude.pt/wp-content/uploads/sites/2/2019/05/Relat_PPCIRA_2015.pdf
European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe 2018 [Internet]. 2019 [cited 2021 mar 02]. Available from: www.ecdc.europa.eu/sites/default/files/documents/surveillance-antimicrobial-resistance-Europe-2018.pdf
World Health Organization. Clean Care is Safer Care. Background to Clean Care is Safer Care [Internet]. 2017 [cited 2021 mar 03]. Available from: http://www.who.int/gpsc/background/en/
Park S, Ko S, An H, Bang J, Chung W. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring. Antimicrobial Resistance and Infection Control [Internet]. 2017 oct 02 [cited 2021 mar 04];6(103). DOI: 10.1186/s13756-017-0263-3
Bianco A, Capano M, Mascaro V, Pileggi C, Pavia M. Prospective surveillance of healthcare-associated infections and patterns of antimicrobial resistance of pathogens in an Italian intensive care unit. Antimicrobial Resistance and Infection Control [Internet]. 2018 apr 3 [cited 2021 mar 06];7(48). DOI: 10.1186/s13756-018-0337-x
Direção-Geral da Saúde. “Feixe de intervenção” de Prevenção de Infeção de local cirúrgico [Internet]. 2015 [cited 2021 mar 27]. Available from: https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0202015-de-15122015-pdf.aspx
World Health Organization. A crescente ameaça da resistência antimicrobiana: Opções de ação [Internet]. 2012 [cited 2021 mar 20];16 p. Available from: https://apps.who.int/iris/bitstream/handle/10665/75389/OMS_IER_PSP_2012.2_por.pdf;jsessionid=9100DFBC7426C549DFFA5CF0911C9A58?sequence=3
European Centre for Disease Prevention and Control. Annual epidemiological report Reporting on 2011 surveillance data and 2012 epidemic intelligence data [Internet]. 2013 [cited 2021 mar 17]. Available from: http://ecdc.europa.eu/en/publications/Publications/annual-epidemiological-report2013.pdf
Jia H, Li L, Li W, Hou T, Ma H, Yang Y. et al. Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China. BioMed Research International [Internet]. 2019 apr [cited 2021 mar 19];(1):1-7. DOI: 10.1155/2019/2590563
Oliveira R, Lopes S. Impacto da infeção do local cirúrgico nas readmissões hospitalares de doentes ortopédicos. [Trabalho de campo para obtenção do grau de Especialista em Administração Hospitalar]. Lisboa (Portugal): Universidade Nova de Lisboa; 2018 [cited 2021 mar 14];67 p. Available from: https://run.unl.pt/bitstream/10362/75721/1/RUN%20-%20Trabalho%20Final%20CEAH%20-%20Rui%20Filipe%20Oliveira.pdf
Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro M, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill [Internet]. 2018 [cited 2021 mar 20];23(46). DOI: 10.2807/1560-7917.ES.2018.23.46.1800516
Iordanou I, Middleton N, Papathanassoglou E, Raftopoulos V. Surveillance of device associated infections and mortality in a major intensive care unit in the Republic of Cyprus. BMC Infectious Diseases [Internet]. 2017 sep 6 [cited 2021 mar 24];17(1):607. DOI: 10.1186/s12879-017-2704-2.
Ruiz-Giardin J, Chamorro I, Ríos L, Aroca J, Arata M, López J et al. Blood stream infections associated with central and peripheral venous catheters. BMC Infectious Diseases [Internet]. 2019 [cited 2021 mar 24];19:841. DOI: 10.1186/s12879-019-4505-2
Metsini A, Vazquez M, Sommerstein R, Marschall J, Voide C, Troillet N, et al. Point prevalence of healthcare-associated infections and antibiotic use in three large Swiss acute-care hospitals. Swiss Med Wkly [Internet]. 2018 apr 26 [cited 2021 mar 25];148. DOI: 10.4414/smw.2018.14617
Huis A, Schouten J, Lescure D, Krein S, Ratz D, Saint S et al. Infection prevention practices in the Netherlands: results from a National Survey. Antimicrobial Resistance and Infection Control [Internet]. 2020 jan 6 [cited mar 26];9(7). DOI: doi.org/10.1186/s13756-019-0667-3
Laan B, Spijkerman I, Godfried M, Pasmooij B, Maaskant J, Borgert M et al. De-implementation strategy to Reduce the Inappropriate use of urinary and intravenous CATheters: study protocol for the RICAT-study. BMC Infectious Diseases [Internet]. 2017 jan 10 [cited mar 19];17(53). DOI: 10.1186/s12879-016-2154-2
Alvim A, Couto B, Gazzinelli A. Epidemiological profile of healthcare-associated infections caused by Carbapenemase-producing Enterobacteriaceae. Rev Esc Enferm USP [Internet]. 2019 [cited mar 19];53. DOI: 10.1590/S1980-220X2018001903474
Slegt J, Laan L, Veen E, Hendriks Y, Romme J, Kluytmans J. Implementation of a Bundle of Care to Reduce Surgical Site Infections in Patients Undergoing Vascular Surgery. PLOS ONE [Internet]. 2013 aug 13 [cited mar 26];8(8):1-7. DOI: 10.1371/journal.pone.0071566.
Wichmann D, Campos C, Ehrhardt S, Kock T, Weber C, Rohde H et al. Efficacy of introducing a checklist to reduce central venous line associated bloodstream infections in the ICU caring for adult patients. BMC Infectious Diseases [Internet]. 2018 jun 08 [cited apr 02];18(267). DOI: 10.1186/s12879-018-3178-6
Bonten, M. Ventilador-Associated Pneumonia: Preventing the Inevitable. Clinical Infectious Diseases [Internet]. 2011 jan 01 [cited mar 28];52(1):115-21. DOI: 10.1093/cid/ciq075
Quartin A, Scerpella E, Puttagunta S, Kett D. A comparison of microbiology and demographics among patients with healthcare-associated, hospital-acquired, and ventilator-associated pneumonia: a retrospective analysis of 1184 patients from a large, international study. BMC Infect Dis [Internet]. 2013 nov 27 [cited mar 17];13(561). DOI: 10.1186/1471-2334-13-561
Sinésio M, Magro M, Carneiro T, Silva K. Fatores de risco às infecções relacionadas à assistência em unidades de terapia intensiva. Cogitare Enf [Internet]. 2018 [cited apr 02];(23)2. DOI: 10.5380/ce.v23i2.53826
Kaye KS, Sloane R, Sexton DJ, Schmader KA. Risk Factors for Surgical Site Infections in Older People. J Am Geriatr Soc [Internet]. 2006 Mar [cited apr 03];54(3):391-6. DOI: 10.5380/ce.v23i2.53826
Torres RA, Torres BR. Importância e bases de um programa de controle e prevenção de infecção em unidade de terapia intensiva geral. Rev Med Minas Gerais [Internet]. 2015 [cited apr 07];25(4):577-82. DOI: 10.5935/2238-3182.20150125
European Centre for Disease Prevention and Control. Healthcare-associated infections acquired in intensive care units: Annual Epidemiological report for 2017 [Internet]. 2019 [cited 2021 apr 10]. Available from: https://www.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-intensive-care-units-annual-epidemiological-1
Center for Disease Control and Prevention. Management of multi—drug-resistant organisms in healthcare settings (2006) [Internet]. 2017 [cited 2021 apr 15]. Available from: https://www.cdc.gov/infectioncontrol/guidelines/mdro/
Różańska A, Chmielarczyk A, Romaniszyn D, Bulanda M, Walkowicz M, Osuch P et al. Antibiotic resistance, ability to form biofilm and susceptibility to copper alloys of selected staphylococcal strains isolated from touch surfaces in Polish hospital wards. Antimicrobial Resistance and Infection Control [Internet]. 2017 aug 14 [cited apr 27];6(80). DOI: 10.1186/s13756-017-0240-x
Direção-Geral da Saúde. Programa de Prevenção e Controlo de Infeções e de Resistência aos Antimicrobianos [Internet]. 2017 [cited apr 28]. Available from: https://www.sns.gov.pt/wp-content/uploads/2017/12/DGS_PCIRA_V8.pdf
Fundação Calouste Gulbenkian. Um futuro para a saúde – todos temos um papel a desempenhar [Internet]. 2014 [cited 2021 apr 18]. Available from: https://content.gulbenkian.pt/wp-content/uploads/2016/03/30003652/PGIS_BrochuraRelatorioCompletoHealthPortugues.pdf
Miranda S, Tavares D. Healthcare-associated infections: is portugal homogeneous? [Dissertação de Mestrado na Internet]. Portugal: Instituto Universitário Egas Moniz. 2020 [cited apr 29]. 62 p. Available from: https://comum.rcaap.pt/bitstream/10400.26/35104/1/Miranda_Sofia_Farinha_Vieira.pdf
Costa, A. Controlo de infecção. Tecno hospital [Internet]. 2011 [cited 2021 may 01];43:13-16. Available from: http://www.tecnohospital.pt/noticias/revista-n43-janeiro-fevereiro-2011/
Vaughn V, Saint S, Krein S, Forman J, Meddings J, Ameling J, et al. Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies. BMJ Qual Saf [Internet]. 2019 jan [cited 2021 may 07];28(1):74–84. DOI: 10.1136/bmjqs-2017-007573
López E, Oleastro M. Infeção por Clostridioides difficile em Portugal, 2018 - Dados da norma do sistema de Vigilância Epidemiológica das Resistências aos Antimicrobianos [Internet]. 2019 [cited 2021 may 08]. Available from: https://repositorio.insa.pt/bitstream/10400.18/7175/1/InfecaoClostridioides_2018.pdf
Benbassat J, Taragin M. Hospital readmissions as a measure of quality of care. Archives of Internal Medicine [Internet]. 2000 apr 24 [cited 2021 may 08];160(8):1074–1081. DOI: 10.1001/archinte.160.8.1074.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Enfermería: Cuidados Humanizados
This work is licensed under a Creative Commons Attribution 4.0 International License.
