Publications by authors named "Sandra Valderrama-Beltran"

Background: Despite declining COVID-19 incidence, healthcare workers (HCWs) still face an elevated risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. We developed a diagnostic multivariate model to predict positive reverse transcription polymerase chain reaction (RT-PCR) results in HCWs with suspected SARS-CoV-2 infection.

Methods: We conducted a cross-sectional study on episodes involving suspected SARS-CoV-2 symptoms or close contact among HCWs in Bogotá, Colombia.

View Article and Find Full Text PDF

Background: Despite the global public health threat posed by carbapenem-resistant Enterobacter spp., clinical and molecular epidemiological studies on international isolates remain scarce. Historically, the taxonomy of Enterobacter has been challenging, limiting our understanding of the clinical characteristics and outcomes of carbapenemase-producing Enterobacter spp.

View Article and Find Full Text PDF

The distribution of carbapenemases in Carbapenem-Resistant Enterobacterales (CRE) has recently undergone a change in our region. According to the Colombian National Institute of Health, there is an increasing prevalence of NDM and NDM-KPC co-producing strains. We carried-out an ambispective cohort study of adult inpatients from Hospital Universitario San Ignacio (2021-2023), infected or colonized with CRE, in which carbapenemases immunochromatographic assay was performed.

View Article and Find Full Text PDF

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden.

Methods: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries.

View Article and Find Full Text PDF

Background: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East.

Methods: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI).

View Article and Find Full Text PDF

Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors.

Design: A prospective cohort study.

Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.

View Article and Find Full Text PDF

Background: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden.

Methods: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates.

View Article and Find Full Text PDF

Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal.

Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods.

View Article and Find Full Text PDF

Purpose: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries.

Methods: From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator.

View Article and Find Full Text PDF

Background: Direct-acting antivirals (DAA) were introduced to Latin America with the aim of eliminating hepatitis C (HCV) in the region. There are scarce data on the outcomes of people living with HIV and HCV treated with these medications in Colombia. This study compares the outcomes of patients with HIV-HCV co-infection and HCV mono-infection treated with DAAs.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how the immune responses (antibodies and CD4 T cells) to SARS-CoV-2 from natural infection and vaccination change over time, focusing on variants like Mu, Gamma, and Delta.
  • It found that antibody levels decline after 6 months, particularly in mildly infected individuals, while those severely infected maintain higher levels; vaccination boosts antibody production but they also decrease over time.
  • The cross-recognition of variants showed varying effectiveness, and prior exposure to the virus influenced the immune response, suggesting important considerations for future vaccine development against emerging variants.
View Article and Find Full Text PDF

Introduction: Long-term use of antiretroviral therapy (ART) for HIV infection might lead to the necessity of switching regimens. We aimed to analyze the reasons for the ART switch, the time-to-switch of ART, and its associated factors in a Colombian cohort.

Methods: We conducted a retrospective cohort in 20 HIV clinics, including participants ≥18 years old with confirmed HIV infection who underwent an ART switch from January 2017 to December 2019 with at least 6 months of follow-up.

View Article and Find Full Text PDF

Introduction: Colombia is the fifth most affected country by the global monkeypox outbreak and the second in LAC after Brazil. We describe the clinical and epidemiological characteristics of 521 patients with mpox in the country.

Methods: We conducted an observational analysis of laboratory-confirmed Mpox cases between June 29 and November 16, 2022.

View Article and Find Full Text PDF

Objectives: To evaluate the association between Colombia's third wave when the Mu variant was predominant epidemiologically (until 75%) in Colombia and COVID-19 all-cause in-hospital mortality.

Methods: In this retrospective cohort, we included hospitalized patients ≥18 years with SARS-CoV-2 infection between March 2020 to September 2021 in ten hospitals from three cities in Colombia. Description analysis, survival, and multivariate Cox regression analyses were performed to evaluate the association between the third epidemic wave and in-hospital mortality.

View Article and Find Full Text PDF

Objective: To identify central-line (CL)-associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs).

Design: From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms.

Setting: The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries.

View Article and Find Full Text PDF

Background: Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health.

View Article and Find Full Text PDF

Methods: Over a four-year period, 123 Candida bloodstream isolates were collected at a quaternary care hospital. The isolates were identified by MALDI-TOF MS and their fluconazole (FLC) susceptibility patterns were assessed according to CLSI guidelines. Subsequently, sequencing of ERG11, TAC1 or MRR1, and efflux pump activity were performed for resistant isolates.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify rates and risk factors for central line-associated bloodstream infections (CLABSI) in 58 ICUs across 8 Latin American countries from 2014 to 2022.
  • A total of 29,385 patients were observed, leading to a CLABSI rate of 4.30 per 1,000 central line days, with significant risk linked to longer hospital stays, more central line days prior to infection, and infections occurring in publicly-owned facilities.
  • The research suggests targeting strategies to reduce length of stay and central line days, and replacing high-risk femoral and internal-jugular lines with PICC lines to mitigate CLABSI risks.
View Article and Find Full Text PDF

Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a global threat, but the distribution and clinical significance of carbapenemases are unclear. The aim of this study was to define characteristics and outcomes of CRPA infections and the global frequency and clinical impact of carbapenemases harboured by CRPA.

Methods: We conducted an observational, prospective cohort study of CRPA isolated from bloodstream, respiratory, urine, or wound cultures of patients at 44 hospitals (10 countries) between Dec 1, 2018, and Nov 30, 2019.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify risk factors for ventilator-associated pneumonia (VAP) in intensive care units (ICUs) of low- and middle-income countries, where VAP rates are significantly higher than in high-income countries.
  • The research was a prospective cohort analysis covering 743 ICUs across 282 hospitals in 42 diverse countries over 24 years, following 289,643 patients for a total of nearly 2 million patient days.
  • Key identified risk factors for acquiring VAP included male sex, prolonged ICU stay, use of mechanical ventilation, and specific ICU admissions (such as oncology and respiratory ICUs), with CPAP showing the highest associated risk.
View Article and Find Full Text PDF

Background: The International Nosocomial Infection Control Consortium (INICC) has found a high ICU mortality rate in Latin America.

Methods: A prospective cohort study in 198 ICUs of 96 hospitals in 46 cities in 12 Latin American countries to identify mortality risk factors (RF), and data were analyzed using multiple logistic regression.

Results: Between 07/01/1998 and 02/12/2022, 71,685 patients, followed during 652,167 patient-days, acquired 4700 HAIs, and 10,890 died.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined the incidence, prevalence, and factors related to SARS-CoV-2 infections among healthcare workers at a university hospital in Bogotá from March 2020 to February 2021.
  • The cumulative incidence of infection was found to be 35.7% with a seroprevalence of 21.5%, highlighting a significant burden among workers.
  • Factors contributing to a higher risk of infection included being a nurse, working in high-risk areas, being overweight or obese, and having close contact with COVID-19 patients, underscoring the need for improved preventative measures.
View Article and Find Full Text PDF