10 results
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Physical and rheological investigation of vegetable oils and their effect as lubricants in mechanical components
- Ricardo Ortega-Álvarez, Guillermo E. Aguilar-Cortés, María T. Hernández-Sierra, Luis D. Aguilera-Camacho, J. S. García-Miranda, Karla J. Moreno
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- Journal:
- MRS Advances / Volume 4 / Issue 59-60 / 2019
- Published online by Cambridge University Press:
- 04 November 2019, pp. 3291-3297
- Print publication:
- 2019
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The aim of this investigation was to study castor, canola, and sesame vegetable oils in order to evaluate their potential use as lubricants in steel mechanical components. For this purpose, densities of each oil were evaluated using the pycnometer method, as well as their dynamic viscosities through a Brookfield DV-II rotational viscometer. Both properties were evaluated at temperatures of 25, 40 and 100 °C. Additionally, viscosity indexes were determined according to ASTM D 2270. These rheological properties were used to estimate the lubrication regime considering parameters of real contact conditions in mechanical components. Friction and wear analyses were carried out to investigate the behaviour of the vegetable oil as lubricants. Such tests were carried out at room temperature on a CSM tribometer with pin-on-disk configuration by using castor, canola and sesame oils as lubricants. AISI 4140 hardened steel against AISI 100Cr6 steel pin was used as a mechanical component. From the rheological study, it was observed that canola and sesame oils behave as dilatant fluids at the evaluated temperatures, while castor oil behaves like a Newtonian fluid at 25 and 40 °C. Castor oil showed the highest density value among oils studied, but it also exhibited the lowest value of viscosity index (271). Contrarily, sesame oil was the least dense, but it exhibited the highest viscosity index (545). On the other hand, the lubrication regime study showed that by using castor oil as a lubricant in the mechanical component (4140/100Cr6), the system worked in a mixed lubrication regime while by using canola and sesame oils the system operated in boundary lubrication conditions. Finally, the kinetic friction coefficients were different for each lubricant obtaining the lowest value with castor oil while the highest value of friction coefficient was exhibited by the sesame oil lubricant.
11 - Conclusion
- Edited by Maria Alvarez, Linde Egberts
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- Book:
- Heritage and Tourism
- Published by:
- Amsterdam University Press
- Published online:
- 22 December 2020
- Print publication:
- 16 March 2018, pp 215-220
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Summary
This book has focused on the intricate but symbiotic relationship between heritage and tourism. As reviewed in the ten chapters included in this work, heritage feeds tourism with its stories and myths, ties to a past that is often glorious but may also be troubled and dark. This imagery is carried out and extended with the help of new technologies that play an intrinsic role in creating experiences for the consumption of the visitors. Thus, in cultural studies, geography, and cultural anthropology, heritage tourism is often framed and perceived as a quest for something authentic, as well as a means of escaping from modernity's sense of alienation. It is associated with turning heritage into a spectacle, an exercise in staged authenticity – in other words, the replacement of a formerly vital tradition that is perceived as more authentic (MacCannell, 1973). Moreover, some believe that the processes of commodification pollute existing cultures (Meethan, 2011). This way of thinking leads Ashworth & van Vroger to assert that “heritage is important to tourism but tourism is not important to heritage” (Ashworth & van Vroger, 2005, p. 196).
Without denying such processes of heritagisation and commodification, we regard this nostalgia and this anxiety about loss of authenticity inherent to what MacDonald calls the memory phenomenon, which encompasses various ways of giving the past a place in the present, whether the vehicle for this be history, memory, or heritage (MacDonald, 2013). The contributions in this book suggest that the relationship between heritage and tourism is more complex than the one Ashworth & van Vroger (2005) perceive. The introduction points out some of the elements that enter into it, and our contributors reflect more deeply on various aspects of this complex connection, which is also the subject of the Heritage Tourism and Hospitality International Conference series that gave rise to this volume.
While we have looked at the role and support that heritage bestows on tourism, the book also contends that tourism has the potential to give meaning to heritage resources. As such, the attention of tourists to local heritage can be a source of communal pride, an acknowledgement of local traditions and practices on the part of a wider audience.
1 - Tourism and Heritage: Crafting Experiences Through Innovation
- Edited by Maria Alvarez, Linde Egberts
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- Book:
- Heritage and Tourism
- Published by:
- Amsterdam University Press
- Published online:
- 22 December 2020
- Print publication:
- 16 March 2018, pp 17-30
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Summary
Throughout modern history, tourism and heritage have had an intimate and reciprocal relationship (Ashworth & van Vroger, 2005). Heritage generates tourism, and the latter, in turn, shapes the meanings, uses and physical characteristics of places of heritage, such as monuments, archaeological sites and museums, as well as townscapes and landscapes. However, academic research into this relationship has been minimal. Occasionally social scientists or economists contribute to international discussions of heritage tourism, but our understanding of the historical and cultural dimensions of the relationship between the two domains is still meagre (Lasansky & Mclaren, 2004).
This book aims to venture across the divide of heritage studies on the one hand and tourism studies on the other. It immediately acknowledges that by pioneering into this underexplored field, it stumbles upon a myriad of academic paradigms, methodologies, and understandings of concepts that are central to this topic (such as tourists, heritage, history, experience, place, image and identity). The book does not choose one approach over another, but rather demonstrates the width of approaches that are used by academics from various disciplinary backgrounds to entangle the intricate relationship between heritage and tourism. By doing so, it adds to the existing corpus of works on this matter, which often focuses on management and preservation issues (cf. Orbasli, 2000; Comer, 2012), leaving conceptual and representational issues out of view. Others address tourism mainly in the context of World Heritage sites (Bourdeau et al., 2015), that form a specific category due to the fact that World Heritage sites are recognised internationally as being valuable and can therefore count on different management structures and intensified tourist destination development due to their high symbolic value. By gathering case studies from Europe as well as other parts of the world, this book illustrates that conflicts, the process of appropriation, and the impact of digitation sometimes have comparable roots, but take on different forms and meanings in varied cultural, geographical, and heritage contexts.
This book addresses heritage that is often perceived as being cultural, to make a clear distinction from natural heritage. Although in many ways this distinction complicates matters more than it solves any conceptual issues, it might be important to draw the reader's attention to the fact that all chapters in this book address places and narratives from human history.
6 - Sustainability of Heritage-Tourism Destinations: A Demand-Based Perspective on Cusco, Peru
- Edited by Maria Alvarez, Linde Egberts
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- Heritage and Tourism
- Published by:
- Amsterdam University Press
- Published online:
- 22 December 2020
- Print publication:
- 16 March 2018, pp 115-130
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Summary
Abstract
Sustainability is a key issue for cultural tourism destinations, which needs to be communicated and marketed to the tourists. Thus, a better understanding of how tourists perceive sustainability attributes in tourism destinations is paramount to support these sustainability initiatives. This study analyses the comments from tourists on Cusco, Peru, posted on the TripAdvisor website during the period of one year. The aim is to understand which sustainability attributes in cultural tourism destinations are most mentioned in these evaluations, and therefore may be considered as most visible and important for tourists. This information is essential in order to provide guidance to cultural destinations wishing to better market their sustainability efforts to their current and potential customers. The research determines that tourists mostly mention aspects pertaining to the protection of the cultural values and unique identity of the destination. These aspects are also those that contribute to create a better experience for the tourists.
Keywords: sustainability, cultural tourism destination, demand-based perspective, tourism experience, Cusco
Introduction
Heritage and tourism are often described in the literature as being interdependent, one supporting the other (Fonseca & Ramos, 2012). Many tourists are motivated to travel to a particular place in order to learn about its history and customs (Fonseca & Ramos, 2012), and thus culture and heritage become important assets that increase the attractiveness of the destination. In return, tourism may support the preservation of the heritage by providing a needed source of capital (Russo & van der Borg, 2002), generating funds that may be used to preserve not only sites, but also intangible values (Salazar & Zhu, 2015). However, while tourism may have a positive impact on destinations, it may also lead to negative results such as commodification of culture and values, gentrification of the sites, and physical damage to their resources from over-visitation (Kaminski, Benson, & Arnold, 2014). In many cases, heritage-led economic development may even result in visitors displacing the inhabitants from their neighbourhoods, putting the fragile ecosystems of historic city centres under threat and thereby negatively impacting the residents’ quality of life.
Thanks to growing awareness and concern about these potential negative impacts of tourism, the idea of sustainability as a sine qua non for tourism development has emerged.
Influence of substrate roughness on the adhesion and tribological performance of Titanium Nitride coating on AISI H13 steel
- Ricardo Ortega-Álvarez, María T. Hernández-Sierra, Benjamín Arroyo-Ramírez, Luis D. Aguilera-Camacho, J. S. García-Miranda, Karla J. Moreno
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- Journal:
- MRS Advances / Volume 3 / Issue 62 / 2018
- Published online by Cambridge University Press:
- 09 October 2018, pp. 3669-3674
- Print publication:
- 2018
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The aim of this research was to investigate the influence of substrate roughness on the adhesion and tribological performance of thin TiN coatings obtained by physical vapor deposition. For that purpose, substrates of AISI H13 steel with surface finishes of 0.06, 0.28 and 0.90 μm in Ra were coated with TiN under the same coating conditions. The chemical composition of the steel, as well as that of the TiN coating, were obtained using EDS analysis. Adhesion tests were carried out following the procedure of BSi 1071-8 standard while hardness was evaluated by ASTM C 1327-03. On the other hand, dry sliding friction tests were conducted with a pin-on-disk tribometer, according to the ASTM G 99-05 standard. This study showed that the roughness of the coating increases as the substrate roughness increases. Regarding adhesion and hardness, all the samples showed an adhesion class 1 according to the standard and a hardness value of 14.51 GPa. Nevertheless, the highest substrate roughness produced the best adhesion. On the other hand, the lowest values for the friction coefficient and wear behavior were obtained by the sample with the lowest substrate roughness of 0.06 µm. In addition, it was found that friction and wear increase when the substrate roughness increases.
Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries
- Victor D. Rosenthal, Bala Ramachandran, Lourdes Dueñas, Carlos Álvarez-Moreno, J. A. Navoa-Ng, Alberto Armas-Ruiz, Gulden Ersoz, Lorena Matta-Cortés, Mandakini Pawar, Ata Nevzat-Yalcin, Marena Rodriguez-Ferrer, Ana Concepción Bran de Casares, Claudia Linares, Victoria D. Villanueva, Roberto Campuzano, Ali Kaya, Luis Fernando Rendon-Campo, Amit Gupta, Ozge Turhan, Nayide Barahona-Guzmán, Lilian de Jesús-Machuca, María Corazon V. Tolentino, Jorge Mena-Brito, Necdet Kuyucu, Yamileth Astudillo, Narinder Saini, Nurgul Gunay, Guillermo Sarmiento-Villa, Eylul Gumus, Alfredo Lagares-Guzmán, Oguz Dursun
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 33 / Issue 7 / July 2012
- Published online by Cambridge University Press:
- 02 January 2015, pp. 696-703
- Print publication:
- July 2012
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Design.
A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.
Setting.Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.
Patients.PICU inpatients.
Methods.We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.
Results.During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21–1.0]), indicating a rate reduction of 57%.
Conclusions.Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
Contributors
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- By Jennifer Alvarez, Ananda B. Amstadter, Metin Başoğlu, David M. Benedek, Charles C. Benight, George A. Bonanno, Evelyn J. Bromet, Richard A. Bryant, Barbara Lopes Cardozo, M. L. Somchai Chakkraband, Claude Chemtob, Roman Cieslak, Lauren M. Conoscenti, Joan M. Cook, Judith Cukor, Carla Kmett Danielson, JoAnn Difede, Charles DiMaggio, Anja J.E. Dirkzwager, Cristiane S. Duarte, Jon D. Elhai, Diane L. Elmore, Yael L.E. Errera, Julian D. Ford, Carol S. Fullerton, Sandro Galea, Freya Goodhew, Neil Greenberg, Lindsay Greene, Linda Grievink, Michael J. Gruber, Sumati Gupta, Johan M. Havenaar, Alesia O. Hawkins, Clare Henn-Haase, Kimberly Eaton Hoagwood, Christina W. Hoven, Sabra S. Inslicht, Krzysztof Kaniasty, Ronald C. Kessler, Rachel Kimerling, Richard V. King, Rolf J. Kleber, Jessica Mass Levitt, Brett T. Litz, Maria Livanou, Katelyn P. Mack, Paula Madrid, Shira Maguen, Paul Maguire, Donald J. Mandell, Charles R. Marmar, Andrea R. Maxwell, Shannon E. McCaslin, Alexander C. McFarlane, Thomas J. Metzler, Summer Nelson, Yuval Neria, Elana Newman, Thomas C. Neylan, Fran H. Norris, Carol S. North, Lawrence A. Palinkas, Benjaporn Panyayong, Maria Petukhova, Betty Pfefferbaum, Marleen Radigan, Beverley Raphael, James Rodriguez, G. James Rubin, Kenneth J. Ruggiero, Ebru Şalcıoğlu, Nancy A. Sampson, Arieh Y. Shalev, Bruce Shapiro, Laura M. Stough, Prawate Tantipiwatanaskul, Warunee Thienkrua, Phebe Tucker, J. Blake Turner, Robert J. Ursano, Bellis van den Berg, Peter G. van der Velden, Frits van Griensven, Miranda Van Hooff, Edward Waldrep, Philip S. Wang, Simon Wessely, Leslie H. Wind, C. Joris Yzermans, Heidi M. Zinzow
- Edited by Yuval Neria, Columbia University, New York, Sandro Galea, University of Michigan, Ann Arbor, Fran H. Norris
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- Book:
- Mental Health and Disasters
- Published online:
- 07 May 2010
- Print publication:
- 20 July 2009, pp xi-xvi
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- By Emily Abbey, Amelia Álvarez, Katia S. Amorim, Ayumu Arakawa, Guglielmo Bellelli, Shoshana Blum-Kulka, Steven D. Brown, Maria Alburquerque Candela, Jorge Castro-Tejerina, Nandita Chaudhary, Sang-Chin Choi, Michael Cole, William A. Corsaro, Alan Costall, Antonietta Curci, Agnes E. Dodds, Gerard Duveen, Yrjö Engeström, Silvia Español, William Mintz Fields, Alex Gillespie, Miguel Gonçalves, Michal Hamo, Gyuseog Han, Ulf Hedetoft, Sophie Hengl, Berit O. Johannesen, Kathryn A. Kavulich, Ayae Kido, Chung-Woon Kim, Jeanette A. Lawrence, Giovanna Leone, Keren Lilu, Eugene Matusov, David Middleton, Hazime Mizoguchi, Fathali M. Moghaddam, Piero Paolicchi, Adolfo Perinat, Pablo del Río, Cintia Rodríguez, Alberto Rosa, M. Clotilde Rossetti-Ferreira, João Salgado, Tatsuya Sato, E. Sue Savage-Rumbaugh, Pär Segerdahl, Jordi Serrallonga, Ana Paula S. Silva, Thomas Slunecko, Mark Smith, Noboru Takahashi, David Travieso, Jaan Valsiner, James V. Wertsch, Toshiya Yamamoto, Yuko Yasuda, Tania Zittoun
- Edited by Jaan Valsiner, Clark University, Massachusetts, Alberto Rosa, Universidad Autónoma de Madrid
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- Book:
- The Cambridge Handbook of Sociocultural Psychology
- Published online:
- 05 June 2012
- Print publication:
- 04 June 2007, pp xiii-xviii
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Device-Associated Infection Rate and Mortality in Intensive Care Units of 9 Colombian Hospitals: Findings of the International Nosocomial Infection Control Consortium
- Carlos Álvarez Moreno, Victor D. Rosenthal, Narda Olarte, Wilmer Villamil Gomez, Otto Sussmann, Julio Garzon Agudelo, Catherine Rojas, Laline Osorio, Claudia Linares, Alberto Valderrama, Patricia Garrido Mercado, Patrick Hernán Arrieta Bernate, Guillermo Ruiz Vergara, Alberto Marrugo Pertuz, Beatriz Eugenia Mojica, María del Pilar Torres Navarrete, Ana Sofia Alonso Romero, Daibeth Henríquez
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 27 / Issue 4 / April 2006
- Published online by Cambridge University Press:
- 21 June 2016, pp. 349-356
- Print publication:
- April 2006
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Objective.
To perform active targeted prospective surveillance to measure device-associated infection (DAI) rates, attributable mortality due to DAI, and the microbiological and antibiotic resistance profiles of infecting pathogens at 10 intensive care units (ICUs) in 9 hospitals in Colombia, all of which are members of the International Infection Control Consortium.
Methods.We conducted prospective surveillance of healthcare-associated infection in 9 hospitals by using the definitions of the US Centers for Disease Control and Prevention National Nosocomial Surveillance System (NNIS). DAI rates were calculated as the number of infections per 100 ICU patients and per 1,000 device-days.
Results.During the 3-year study, 2,172 patients hospitalized in an ICU for an aggregate duration of 14,603 days acquired 266 DAIs, for an overall DAI rate of 12.2%, or 18.2 DAIs per 1,000 patient-days. Central venous catheter (CVC)–related bloodstream infection (BSI) (47.4% of DAIs; 11.3 cases per 1,000 catheter-days) was the most common DAI, followed by ventilator-associated pneumonia (VAP) (32.3% of DAIs; 10.0 cases per 1,000 ventilator-days) and catheter-associated urinary tract infection (CAUTI) (20.3% of DAIs; 4.3 cases per 1,000 catheter-days). Overall, 65.4% of all Staphylococcus aureus infections were caused by methicillin-resistant strains; 40.0% of Enterobacteriaceae isolates were resistant to ceftriaxone and 28.3% were resistant to ceftazidime; and 40.0% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones, 50.0% were resistant to ceftazidime, 33.3% were resistant to piperacillin-tazobactam, and 19.0% were resistant to imipenem. The crude unadjusted attributable mortality was 16.9% among patients with VAP (relative risk [RR], 1.93; 95% confidence interval [CI], 1.24-3.00; P = .002); 18.5 among those with CVC-associated BSI (RR, 2.02; 95% CI, 1.42-2.87; P<.001); and 10.5% among those with CAUTI (RR, 1.58; 95% CI, 0.78-3.18; P = .19).
Conclusion.The rates of DAI in the Colombian ICUs were lower than those published in some reports from other Latin American countries and were higher than those reported in US ICUs by the NNIS. These data show the need for more-effective infection control interventions in Colombia.