C. Castañeda

Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis

Acinetobacter baumannii has emerged as a major cause of healthcare-associated infections. Controversy exists as to whether antimicrobial resistance increases the risk of mortality. We conducted a systematic review and meta-analysis to examine this association. We searched MEDLINE and EMBASE databases up to May 2013 to identify studies comparing mortality in patients with carbapenem-resistant A. baumannii (CRAB) vs. carbapenem-susceptible A. baumannii (CSAB). A random-effects model was used to pool Odds Ratios (OR). Heterogeneity was examined using I(2). We included 16 observational studies. There were 850 reported deaths (33%) among the 2546 patients. Patients with CRAB had a significantly higher risk of mortality than patients with CSAB in the pooled analysis of crude effect estimates (crude OR = 2.22; 95% CI = 1.66, 2.98), although substantial heterogeneity was evident (heterogeneity I(2) = 55%). The association remained significant in the pooled adjusted OR of 10 studies. Studies reported that patients with CRAB compared to patients with CSAB were more likely to have severe underlying illness and also to receive inappropriate empirical antimicrobial treatment, which increases the risk of mortality. Our study suggests that carbapenem resistance may increase the risk of mortality in patients with A. baumannii infection. However, cautious interpretation is required because of the residual confounding factors and inadequate sample size in most studies.

Priorización para el análisis de información en salud pública, preferencias de la red de conocimiento del Observatorio Nacional de Salud

OBJECTIVE To prioritize diseases, population and methods of analysis in public health according to the preferences of the stakeholders of the knowledge network of the National Health Observatory. METHOD The conjoint analysis methodology (AC) was used; it consists on the construction of a complete factorial model taking a random sample of subjects that must identify the preferences of the attributes of a given construct according to a pre-established order of importance. The stakeholders of the knowledge network who participated were professionals from public universities, members of health promotion entities, health provision services, health departments, non-profit health organizations, specialized research centers, mayors offices, and corporations. RESULTS The groups of priority diseases were mental and behavioral disorders (13.8%), cardiovascular and circulatory diseases (13%), neoplasms (10%), diarrhea, respiratory infections, meningitis and other common infectious diseases (6.7%), and nutritional deficiencies (6.3 %). The preferred prioritization criteria were the burden of disease and high-impact epidemiological dynamics. The analysis of priority information was the analysis of social determinants. The most preferred population was the general population. CONCLUSIONS Participants perceive both chronic and infectious diseases as a priority, which is consistent with the epidemiological transition of the country. The priority for the Colombian health system is to strengthen the capacity of human resources and the surveillance system in different areas to have a better decision-making process in relation to public health.

PIN18 IMPACTO EPIDEMIOLÓGICO Y ECONÓMICO DE LA INTRODUCCIÓN DE LA VACUNA DE INFLUENZA EN COLOMBIA

PIN15 EVALUACIÓN ECONÓMICA DEL IMPACTO DE LA INTRODUCCIÓN DE LA VACUNA DE HEPATITIS A EN BOGOTÁ D.C de La Hoz F, Alvis N, Narváez J, Pérez B Universidad Nacional de Colombia, Bogotá D.C, Colombia, Universidad de Cartagena, Cartagena, Colombia OBJECTIVOS: Estimar la carga de enfermedad por hepatitis A en Bogotá y modelar el impacto epidemiológico y económico de la introducción de la vacuna de hepatitis A. METODOLOGÍAS: Estimación epidemiológica basada en una revisión sistemática de literatura de bases de datos nacionales e internacionales, y estudio de evaluación económica del impacto de la introducción de la vacuna. RESULTADOS: Se estimó que durante el 2007, en el escenario sin vacunación, en Bogotá se produjeron entre 59,333 y 73,192 casos de infección por hepatitis A en menores de 15 años. De éstos desarrollarían enfermedad ictérica entre 19,721 y 22,602, se generarían entre 3126 y 3531 hospitalizaciones, presentarían falla hepática entre 59 y 68, y se esperarían entre 36 y 41 muertes. El costo directo total de la atención de la carga de enfermedad por hepatitis A en Bogotá se estimó en US

Impact of carbapenem resistance on clinical and economic outcomes among patients with Acinetobacter baumannii infection in Colombia.

2.97 millones (US

Incidencia de cáncer de piel en Colombia, años 2003-2007

2.4–3.9 millones, US

PIN23 COST-EFFECTIVENESS OF PNEUMOCOCCAL VACCINE POLYVALENT (PPSV23) IN ADULTS OLDER THAN 60 YEARS OLD IN COLOMBIA

de 2007). Si se introduce la vacunación con una dosis los costos de atención se reducirían en US

Costos de la prueba de tamizaje para Chagas en donantes de dos Bancos de Sangre de Colombia, 2015

2.5 millones y con dos dosis en US

La flexibilizacion laboral en Colombia

2.8 millones. La vacunación con cualquiera de los esquemas evitaría cerca de 34 muertes y 7 años de vida ajustados por discapacidad (AVAD). En los dos escenarios la vacunación resulta costo-ahorrativa. Con una dosis salvar un AVAD representa un ahorro de US

Labor flexibilization in Colombia

239 y evitar una muerte ahorra US

PCN68 Cost-Effectiveness of HER-2-Positive Metastatic-Breast-Cancer Treatment in Post-Herceptin Progression in Colombia

62,924; con dos dosis el ahorro sería de US