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Am J Infect Control. 2016 Nov 1;44(11):1296-1301. doi: 10.1016/j.ajic.2016.04.212. Epub 2016 Jun 20.

National surveillance of health care-associated infections in Egypt: Developing a sustainable program in a resource-limited country.

Author information

1
Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt. Electronic address: maha.m.talaat.ctr@mail.mil.
2
Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt; Ain Shams University Hospitals, Cairo, Egypt.
3
Cairo University Hospitals, Cairo, Egypt.
4
Ain Shams University Hospitals, Cairo, Egypt.
5
Global Disease Detection Center, US Centers for Disease Control and Prevention, Cairo, Egypt; US Naval Medical Research Unit, No. 3, Cairo, Egypt.
6
Alexandria University Hospitals, Alexandria, Egypt.
7
Ministry of Health and Population, Cairo, Egypt.
8
Centers for Disease Control and Prevention, Atlanta, GA.

Abstract

BACKGROUND:

Health care-associated infections (HAIs) are a major global public health concern. The lack of surveillance systems in developing countries leads to an underestimation of the global burden of HAI. We describe the process of developing a national HAI surveillance program and the magnitude of HAI rates in Egypt.

METHODS:

The detailed process of implementation of a national HAI surveillance program is described. A 3-phase surveillance approach was implemented in intensive care units (ICUs). This article focuses on results from the phase 2 surveillance. Standard surveillance definitions were used, clinical samples were processed by the hospital laboratories, and results were confirmed by a reference laboratory.

RESULTS:

Ninety-one ICUs in 28 hospitals contributed to 474,544 patient days and 2,688 HAIs. Of these, 30% were bloodstream infections, 29% were surgical site infections, 26% were pneumonia, and 15% were urinary tract infections. Ventilator-associated pneumonia had the highest incidence of device-associated infections (4.3/1,000 ventilator days). The most common pathogens reported were Klebsiella spp (28.7%) and Acinetobacter spp (13.7%). Of the Acinetobacter spp, 92.8% (157/169) were multidrug resistant, whereas 42.5% (151/355) of the Klebsiella spp and 54% (47/87) of Escherichia coli were extended-spectrum β-lactamase producers.

CONCLUSIONS:

Implementation of a sustainable surveillance system in a resource-limited country was possible following a stepwise approach with continuous evaluation. Enhancing infection prevention and control programs should be an infection control priority in Egypt.

KEYWORDS:

Health care–associated infections; antimicrobial resistance; surveillance in intensive care units

PMID:
27339791
DOI:
10.1016/j.ajic.2016.04.212
[Indexed for MEDLINE]
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