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“Our goal must be a world in which good health is a pillar of individual well-being, national progress, and international stability and peace. This cannot be achieved without partnerships involving governments, international organizations, the business community, and civil society.”

— Kofi A. Annan, ex-Secretary-General of the United Nations

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Background
Infections acquired in health care facilities occur worldwide and affect both developed and resource-poor countries. These infections are among the major causes of death and morbidity among hospitalized patients and a significant burden for both the patient and for public health.

Infection 2

Nearly 90% of hospitals in Latin America lack the personnel and proper procedures to prevent and control hospital-acquired infections, despite the elevated rates of these infections and their associated morbidity, mortality, and high cost. Many hospitals do not have adequate laboratories and lack crucial data for determining appropriate antimicrobial therapy and infection control practices. Several countries also lack regulations and policies to compare the true extent of these problems. Little knowledge exists on how these infections affect particularly vulnerable populations, such as indigenous people, premature babies, young children and the elderly.

Health Challenges

  • The rates of infection in resource-poor countries tend to be twice as high as in developed countries.
  • At any time, over 1.4 million people worldwide suffer from infectious complications acquired in health care facilities; 50% of them are caused by pathogens resistant to common antibiotics.
  • The most frequent are urinary tract infections, lower respiratory tract infections, and infections of surgical wounds.
  • Infection rates are higher among patients with increased susceptibility because of extremes of age, underlying disease, chemotherapy, surgery or invasive procedures.

Impact
Health care facility-acquired infections can cause functional disability and emotional stress that may reduce the quality of life. The advancing age of hospitalized patients has produced a greater prevalence of chronic infections, many caused by antibiotic resistant strains. These organisms may spread to the community when these patients are discharged.

The economic costs of these infections are considerable. The increased length of hospital stays for infected patients is the greatest contributor to cost. Prolonged stay not only raises direct costs to patients but also indirect costs due to lost work. The increased use of drugs, the need for isolation, and the use of additional laboratory and other diagnostic studies also contribute to costs.

Bacterial Resistance
The widespread use of antimicrobial drugs produces pressure on bacteria that favors the selection of multi-drug resistant strains. Such organisms can become endemic within the hospital and complicate the management of health-setting acquired infections. Increasingly, antimicrobial agents are becoming less and less effective because of resistance. This phenomenon has rendered many of the older antibiotics ineffective and is also increasingly negating the efficacy of the newer antibiotics to the point that for certain strains there are few or no effective alternatives. This problem becomes critical in developing countries where newer, more expensive, antibiotics may not be available or affordable.

Potential Impact of a PAHEF Initiative
The Pan American Health Organization (PAHO) has been working for several years to establish a network of microbiology laboratories throughout Latin America that operates under international standards of quality control. The data from these laboratories are beginning to show the magnitude of the problem of antimicrobial resistance in Latin America. The problem is serious and the efforts should be carried to the next step: the integration of culture data (obtained from laboratories that follow good laboratory practices) with infection control and prevention practices with national antibiotic use. It is imperative to identify the best practices that would prevent health setting-acquired infections and improve the quality of life while decreasing the risk of antibiotic resistance in hospitals.

The Foundation has a significant three-pronged initiative in infection control underway in Bolivia. Click here to read more!

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