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2020. Impact of Local Antimicrobial Stewardship Guidelines through a Cellphone App to Lower Hospital-acquired MDR Infections in a Private Hospital in Mexico City

BACKGROUND: Hospital-acquired multi-drug-resistant organisms (HA-MDRO) infections are associated with increased cost, length of stay, morbidity, and mortality. The prevalence of HA-MDRO has been increasing worldwide. We look to describe how the implementation of local guidelines as an app available...

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Detalles Bibliográficos
Autores principales: Villanueva Reza, Marco, Lanz-Zubiria, Lorena, Rojas de Ita, Israel, Castañeda-Méndez, Paulo, Aleman Aguilar, Esperanza, Aguilar-Zapata, Daniel, Soto-Ramirez, Luis E, Reyes Mar, Javier, Lorena Cabrera Ruiz, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808779/
http://dx.doi.org/10.1093/ofid/ofz360.1700
Descripción
Sumario:BACKGROUND: Hospital-acquired multi-drug-resistant organisms (HA-MDRO) infections are associated with increased cost, length of stay, morbidity, and mortality. The prevalence of HA-MDRO has been increasing worldwide. We look to describe how the implementation of local guidelines as an app available for tablets or cellphones in our hospital in 2014 decrease the prevalence of HA-MDRO. METHODS: Local guidelines were implemented as an electronic application available and intended for hospital staff only. This app gives local patterns of resistance for bacteria with treatment recommendations alongside suggested antimicrobial drugs for empiric treatment. Descriptive statistics were performed. RESULTS: In 2013, before implementing the app, HA-MDRO were reported in 25% of hospital-acquired infection. After the introduction of the app, compliance in 2014 was 56.7% with HA-MDRO reported in 20%, 2015 use was 60.7% and HA-MDRO in 18%, 2016 compliance 68.7% and HA-MDRO in 16%, 2017 compliance in 73.7% and HA-MDRO in 14%, lastly in 2018 prevalence was 15% of HA-MDRO while use of local guidelines was 78.7%. Different type of infections (VAP, HAP, UTI, SSI, BSI) also decreased while following guidelines recommendations. CONCLUSION: These programs are needed as a part of the healthcare program to control the HA-MDRO morbidity and complications. Simple friendly-user electronic applications such as the one implemented in our hospital led to higher compliance and lower hospital-acquired infections. Antimicrobial stewardship programs and local guidelines should be part of the standard of care of all hospitals. [Image: see text] DISCLOSURES: All authors: No reported disclosures.