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

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

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Authors

Reginaldo Luz

Denise Brandão de Assis

Geraldine Madalosso

STEPHEN TIMMONS stephen.timmons@nottingham.ac.uk
Professor of Health Services Management

Maria Clara Padoveze



Abstract

Purpose: To describe the implementation process and the preliminary results of a surveillance system for healthcare-associated endophthalmitis. Methods: This is a case study of the implementation of a surveillance system for healthcare-associated endophthalmitis. The system for healthcare-associated endophthalmitis is a structured system that enables surveillance of cases of healthcare-associated endophthalmitis after intraocular procedures, developed and coordinated by the Division of Hospital Infection at the State Health Department, São Paulo, Brazil. The implementation process included a pilot phase, followed by a scaling-up phase. Data were reported monthly to the Division of Hospital Infection by participating healthcare facilities that performed intraocular procedures in the state of São Paulo, Brazil, from September 2017 to December 2019. Results: Among the 1,483 eligible healthcare facilities, 175 engaged in the study (participation rate of 11.8%), reporting 222,728 intraocular procedures performed, of which 164,207 were cataract surgery and 58,521 were intravitreal injections. The overall incidence rate of endophthalmitis was reported to be 0.05% (n=105; 80 cases after cataract surgery and 25 cases after intravitreal injections). The incidence rates for healthcare facilities 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. This system for healthcare-associated endophthalmitis enabled the identification of an outbreak of four cases of endophthalmitis after intravitreal injections. Conclusion: The system for healthcare-associated endophthalmitis proved to be operationally viable and efficient for monitoring cases of endophthalmitis at the state level.

Citation

Luz, R., Brandão de Assis, D., Madalosso, G., Timmons, S., & Padoveze, M. C. (2023). Surveillance system for Healthcare-associated endophthalmitis at state level in a middle-income country: preliminary results. Arquivos Brasileiros de Oftalmologia, 87(4), Article e2022-0181. https://doi.org/10.5935/0004-2749.2022-0181

Journal Article Type Article
Acceptance Date Sep 7, 2022
Publication Date 2023
Deposit Date Sep 9, 2022
Publicly Available Date Dec 31, 2023
Journal Arquivos Brasileiros de Oftalmologia
Print ISSN 0004-2749
Electronic ISSN 1678-2925
Peer Reviewed Peer Reviewed
Volume 87
Issue 4
Article Number e2022-0181
DOI https://doi.org/10.5935/0004-2749.2022-0181
Keywords Epidemiological monitoring; Endophthalmitis; Delivery of healthcare; Health surveys; Ophthalmologic surgical procedures
Public URL https://nottingham-repository.worktribe.com/output/10919743
Related Public URLs https://www.scielo.br/j/abo/a/TTwqQDJxRpy87VnMGB8DRys/?format=pdf&lang=en

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