Geographical information system and spatial–temporal statistics for monitoring infectious agents in hospital: a model using Klebsiella pneumoniae complex

Antimicrobial Resistance & Infection Control

Maria Helena B. Pereira¹  Claudio Neder Candella²  Fabiola A. da Silva³  Wagner S. Tassinari⁴  Elisangela Martins de Lima⁵  Marcio Zenaide de Oliveira Alves⁵  Christovam Barcellos⁶  Leonardo Passos Souza⁷  Newton D. Lourenço⁷  Caio Augusto Santos Rodrigues⁷  Priscila Pinho da Silva⁸  Marisa Zenaide Ribeiro Gomes⁹ 

[1] Admitting Office, HFSE, Rio de Janeiro, RJ, Brazil;Department of Engineering, Hospital Federal Dos Servidores Do Estado (HFSE), Rio de Janeiro, RJ, Brazil;Department of Engineering, Hospital Federal Dos Servidores Do Estado (HFSE), Rio de Janeiro, RJ, Brazil;Rio de Janeiro State University, Rio de Janeiro, Brazil;Department of Mathematics, The Federal Rural University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil;Evandro Chagas National Institute of Infectious Diseases, FIOCRUZ, Rio de Janeiro, Brazil;Hospital Infection Control Committee, HFSE, Rio de Janeiro, RJ, Brazil;Institute of Scientific and Technological Communication and Information in Health, FIOCRUZ, Rio de Janeiro, RJ, Brazil;Laboratory of Microbiology, HFSE, Rio de Janeiro, RJ, Brazil;Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz - Fundação Oswaldo Cruz, Avenida Brasil, 4365, Pavilhão Leônidas Deane, 6º andar, sala 607, 21040-900, Rio de Janeiro, RJ, Brazil;Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz - Fundação Oswaldo Cruz, Avenida Brasil, 4365, Pavilhão Leônidas Deane, 6º andar, sala 607, 21040-900, Rio de Janeiro, RJ, Brazil;Hospital Infection Control Committee, HFSE, Rio de Janeiro, RJ, Brazil;

关键词: Surveillance;    Hospital infection;    Antimicrobial resistance;    Klebsiella pneumoniae;    Time series;    Geographic information system;    Spatial–temporal statistics;   

DOI  :  10.1186/s13756-021-00944-5

来源: Springer

【 摘 要 】

BackgroundThe emergence and spread of antimicrobial resistance and infectious agents have challenged hospitals in recent decades. Our aim was to investigate the circulation of target infectious agents using Geographic Information System (GIS) and spatial–temporal statistics to improve surveillance and control of healthcare-associated infection and of antimicrobial resistance (AMR), using Klebsiella pneumoniae complex as a model.MethodsA retrospective study carried out in a 450-bed federal, tertiary hospital, located in Rio de Janeiro. All isolates of K. pneumoniae complex from clinical and surveillance cultures of hospitalized patients between 2014 and 2016, identified by the use of Vitek-2 system (BioMérieux), were extracted from the hospital's microbiology laboratory database. A basic scaled map of the hospital’s physical structure was created in AutoCAD and converted to QGis software (version 2.18). Thereafter, bacteria according to resistance profiles and patients with carbapenem-resistant K. pneumoniae (CRKp) complex were georeferenced by intensive and nonintensive care wards. Space–time permutation probability scan tests were used for cluster signals detection.ResultsOf the total 759 studied isolates, a significant increase in the resistance profile of K. pneumoniae complex was detected during the studied years. We also identified two space–time clusters affecting adult and paediatric patients harbouring CRKp complex on different floors, unnoticed by regular antimicrobial resistance surveillance.ConclusionsIn-hospital GIS with space–time statistical analysis can be applied in hospitals. This spatial methodology has the potential to expand and facilitate early detection of hospital outbreaks and may become a new tool in combating AMR or hospital-acquired infection.

【 授权许可】

CC BY