Surveillance system for healthcare-associated endophthalmitis at state level in a middle- income country: preliminary results

Luz, Reginaldo; Assis, Denise; Madalosso, Geraldine; Timmons, Stephen; Padoveze, Maria Clara

Abstract

Purpose: To describe the implementation process and the preliminary results of a surveillance system for healthcare-associated endophthalmitis (SIVEN). Methods: This is a case study of the implementation of a surveillance system for healthcare-associated endophthalmitis (SIVEN). The SIVEN is a structured system that enables surveillance of cases of healthcare-associated endophthalmitis after intraocular procedures (IPs), developed and coordinated by the Division of Hospital Infection (DHI) at the State Health Department, São Paulo, Brazil. The implementation process included a pilot phase, followed by the scaling-up phase. Data were reported monthly to DHI by participating health facilities (HFs) that performed IPs in the state of São Paulo, Brazil from September 2017 to December 2019. Results: Among the 1,483 eligible HFs, 175 engaged in the study (participation rate of 11.8%), reporting 222,728 IPs performed, of which 164,207 were cataract surgery and 58,521 were intravitreal injections. The overall incidence rate of endophthalmitis reported was 0.05% (n=105; 80 cases after cataract surgery and 25 cases after intravitreal injections). HFs incidence rates ranged from 0.02% to 4.55%. Most cases were caused by gram-positive bacteria, mainly Staphylococcus spp. In 36 (46.2%) of the cases there was no bacterial growth; no sample was collected in 28 (26.7%) cases. SIVEN enabled the identification of an outbreak of four cases of endophthalmitis after intravitreal injections. Conclusion: The SIVEN proved to be operationally viable and efficient for monitoring cases of endophthalmitis at state level.

Citation

Luz, R., Assis, D., Madalosso, G., Timmons, S., & Padoveze, M. C. (in press). Surveillance system for healthcare-associated endophthalmitis at state level in a middle- income country: preliminary results. Arquivos Brasileiros de Oftalmologia,

• Journal Article Type: Article
• Acceptance Date: Sep 7, 2022
• Deposit Date: Sep 9, 2022
• Journal: Arquivos Brasileiros de Oftalmologia
• Print ISSN: 0004-2749
• Electronic ISSN: 1678-2925
• Peer Reviewed: Peer Reviewed
• Public URL: https://nottingham-repository.worktribe.com/output/10919743