Attributable cost and length of stay for patients with central venous catheter-associated bloodstream infection in Mexico City intensive care units: a prospective, matched analysis.

BACKGROUND: No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico. OBJECTIVE: To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City. DESIGN: An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI. SETTING: Adult ICUs in 3 hospitals in Mexico City. PATIENTS AND METHODS: A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments. RESULTS: For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was US dollars 598, the mean extra hospital cost was US dollars 11,591, and the attributable extra mortality was 20%. CONCLUSIONS: In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.

[Nosocomial infection surveillance: experience at a cardiology hospital in Mexico]. / Vigilancia de infecciones nosocomiales: experiencia de un hospital de cardiología en México.

OBJECTIVE: To describe the results of the Nosocomial Infection surveillance program at the Cardiology Hospital in Centro Médico Nacional Siglo XXI of the Mexican Social Security Institute. METHODOLOGY: To inform of the epidemiologic follow-up results from January 2000 to July 2003. Global frequency, infection rates by infection site, hospital services, and frequency of most common microorganisms were estimated. RESULTS: During this period, global incidence showed that in every 100 discharges, there were 4.3 infections (4.3/100). Frequency of infection was slightly higher in the surgical intensive care unit. Average infection rate in lower respiratory tract infections was 27/1,000; in surgical-site infections: 8/1,000 (mediastinitis 0.8/1,000); it was found that in urinary tract infection, rate was 6.6/1,000. Most commonly isolated microorganisms were: coagulase-negative Staphylococcus (25%), Enterobacter sp. (17%), Candida albicans (13%), S. aureus (9%), P. aeruginosa (9%) and K. pneumoniae (6%). CONCLUSION: This study describes the epidemiology of nosocomial infections in a Cardiology Hospital. The information is obtained through epidemiologic follow-up programs. This information is very important to develop specific strategies for control of infections.