Federal District records drop in infections in hospital ICUs

The average infection rate in intensive care units (ICUs) of hospitals in the Federal District – public, complementary and military administration units – presents a rate below that recorded in the national average, in addition to showing an improvement compared to previous years. This is what the report from the Health Surveillance Directorate (Divisa) of the Department of Health (SES-DF) reveals.

“Infections related to care and microbial resistance are considered public health emergencies and require responsibility and a lot of dedication to be prevented”, explains the Health Surveillance Risk in Health Services (GRSS) manager, Fabiana de Mattos Rodrigues.

All 41 hospitals that have ICUs, according to the professional, have already reported data to Divisa. The goal established by the National Health Surveillance Agency (Anvisa) was to reach the rate of 95% next year.

Lower infection rates in DF

The results show evolution. According to Divisa, which uses a calculation index based on the number of cases per 1,000 patients per day of hospitalization, in 2023, there were 4.3 records of pneumonia associated with mechanical ventilation (VAP) in the average ICU in the DF . In 2021, the number had peaked at 7. By 2022, it had fallen to 5.5, below the national average of 12.5. There are no national numbers for 2023 yet.

Urinary tract infections associated with indwelling bladder catheters (UTI-AC) fell from 3.2 in 2014 to 1 in 2023, using the same calculation basis. The DF average remained below the national average throughout the entire period, which was 3.5 in 2022. For primary bloodstream infection associated with central catheters (IPCSL), in 2022 the national average had been 4 and that of the DF of 2.4. In 2023, the local index fell to 2.2.

In the 14 hospitals with pediatric ICUs there is also a decrease in infections. The federal capital shows a drop in rates for cesarean sections, breast implant surgeries, neurological internal bypass surgeries and in cases of IPCSL and VAP in most weight ranges of babies admitted to neonatal units.

Constant work

Despite the good news, Rodrigues highlights the importance of constant surveillance work. “There is an improvement in rates, but we always need to rely on the effort of hospital teams and continuous monitoring,” he says. One of the biggest concerns is the existence of “superbugs”, resistant to most treatments, as well as the spread of infections to the point where it is necessary to close entire hospital wings in case of outbreaks.

To avoid this scenario, GRSS carries out a thorough analysis of the reported data and maintains close contact with the hospital infection control services at each establishment. Units that do not comply with the legislation are subject to sanctions.

An example of this work is seen at the Hospital Regional de Ceilândia (HRC), where there is routine training for everyone involved in care, from managers to those responsible for cleaning, including health professionals, security guards and visitors. There are also specific instructions for preparing and distributing food, changing bedding, clothing and cleaning the environment.

The head of the Hospital Infection Control nucleus at HRC, Franciely Pabline, says that care is taken daily with all patients occupying the hospital’s 359 beds, including ICUs, wards, obstetric center and other sectors. “We operate mainly in critical areas of the hospital, in adult and neonatal ICUs, obstetric centers, surgical centers and the sterile material center,” she says.

The hospital’s numbers reveal the size of the challenge. In 2023 alone, the HRC recorded more than 77,000 emergency visits, 6,100 inpatient surgeries, 2,500 daily ICU stays and almost 4,000 births. After each hospital discharge, there is a so-called “terminal” cleaning, when bed linen is changed and sanitized and all surfaces are disinfected, including the ceiling and walls. Even patients who enter the surgical center in serious condition, such as victims of accidents or violence, undergo asepsis before the procedures.

Inside the hospital, there are also invisible limits respected by employees. Before entering the operating room or ICU, for example, you need to change your clothes. After that, to leave, you need to make a new exchange. The provision of alcohol gel, the use of masks when necessary and strict regulations on props and accessories also make up the list of measures to prevent infections.

*With information from the Federal District Health Department (SES-DF)