Encuesta de las medidas de control de Staphylococcus aureusresistente a meticilina en los hospitales que participan en el programa VINCat / Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program

INTRODUCCIÓN: VINCat es un programa de vigilancia de la infección nosocomial en los hospitales de Cataluña. El objetivo del estudio fue evaluar el cumplimiento de las medidas de control de Staphylococcus aureus resistente a meticilina (SARM) en dichos centros. MÉTODOS: De enero a marzo de 2013 se realizó una encuesta por correo sobre las características de los hospitales y la aplicación de las medidas de control de SARM. RESULTADOS: Respondieron 53 hospitales (>500 camas: 7; 200-500 camas: 14;<200 camas: 32; tenían UCI: 29). Disponían de alerta informática de reingresos el 63%. Realizaban vigilancia activa de los traslados de otro hospital el 46,2%, o centro de larga estancia el 55,8%, siendo ambas medidas significativamente más frecuentes en hospitales con una tasa de SARM≤22% (mediana global). Observaban el cumplimento de higiene de manos el 77,4% de los centros y fue mayor al 50% en el 69,7%. Todos los hospitales aplicaban precauciones de contacto, aunque el 62,3% no disponían de material clínico de uso frecuente exclusivo. La limpieza de la habitación se realizaba más frecuentemente en el 54,7% y tenían programas de adecuación del uso de antibióticos el 67,9%. CONCLUSIONES: Este estudio informa sobre la implementación de medidas preventivas de SARM en hospitales del programa VINCat. Aunque la mayoría de los hospitales disponen de un protocolo específico, el cumplimento de las medidas es mejorable, especialmente la detección activa en pacientes de riesgo, la adherencia a la higiene de manos, la limpieza más frecuente de la habitación y la optimización del uso de antibióticos

INTRODUCTION: VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS: An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS: A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS: This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics

[Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program]. / Encuesta de las medidas de control de Staphylococcus aureus resistente a meticilina en los hospitales que participan en el programa VINCat.

INTRODUCTION: VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS: An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS: A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS: This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics.

La docencia de la patología infecciosa en los estudios de grado de medicina / Teaching of Infectious Diseases in Medical Degree Studies

Definimos la docencia de la patología infecciosa en losestudios de grado de medicina como el conjunto deactividades destinadas a proporcionar al alumno un nivelde competencia en esta área (conocimientos, habilidades yactitudes) adecuado para un médico recién licenciado, asícomo a dotarle de una base sólida para poder adquirir enel futuro las competencias propias de un especialista.En el momento actual, la ubicación, la dimensión y lascompetencias de la patología infecciosa en el grado demedicina son muy heterogéneas en las distintas facultadesespañolas. La próxima incorporación al espacio europeo deeducación superior, con la necesaria adecuación de losplanes de estudio, comportará una mejor definición de loscontenidos y objetivos docentes de esta materia. El último documento de la Conferencia de Decanos de Facultades de Medicina identifica claramente la asignatura de patología infecciosa y la sitúa en el módulo de patologías médicas dentro del bloque de formación clínica humana. En nuestra opinión, la patología infecciosa debe plantearse como unaasignatura troncal situada preferentemente en el segundosemestre del quinto curso y disponer de un mínimo de 6 yun máximo de 9 créditos ECTS, entre teóricos y prácticos,distribuidos equitativamente en créditos presenciales,semipresenciales y de formación autónoma. La asignaturadebe tener una integración horizontal con la mayoría deasignaturas que conforman el bloque clínico y unaintegración vertical con la asignatura de microbiología. La coordinación de la asignatura y la impartición de la mayor parte de los créditos deben corresponder a especialistas con actividad clínica en enfermedades infecciosas

The teaching of the infectious diseases in the Bachelor of Medicine degree consists of activities aimed at providing the student with levels of competence in this area (knowledge, abilities, attitudes) appropriate for a general physician, and to give them a solid base to achieve the skills and abilities for becoming a specialist in this area. Currently, the location, the amount and quality of infectious diseases studies in the Bachelor of Medicine degree are very disparate between the different Spanish Medical Schools. The incorporation into the European Higher Education Area, with the necessary adaptation of curricula, will enable the contents and the teaching objectives in this field to be better defined. The latest document from the Medical Schools Deans Conference clearly identifies the studies of the infectious diseases into the Medical Diseases module and in the area of human clinical training. In our opinion, infectious diseases must be considered as a major subject, preferably in the second semester of the fifth year, and having a minimum of 6 anda maximum of 9 ECTS, theoretical and practical,distributed equally among attendance, part-attendanceand self-teaching credits. Infectious diseases pathologymust be horizontally integrated with most of the othersubjects in the clinical module and vertically integratedwith the subject of microbiology. The coordination andmost of the teaching of the credits in the infectiousdiseases subject must be done by specialists with clinical activity in infectious diseases (AU)

La docencia de la patología infecciosa en los estudios de grado de medicina / Teaching of Infectious Diseases in Medical Degree Studies

Definimos la docencia de la patología infecciosa en losestudios de grado de medicina como el conjunto deactividades destinadas a proporcionar al alumno un nivelde competencia en esta área (conocimientos, habilidades yactitudes) adecuado para un médico recién licenciado, asícomo a dotarle de una base sólida para poder adquirir enel futuro las competencias propias de un especialista.En el momento actual, la ubicación, la dimensión y lascompetencias de la patología infecciosa en el grado demedicina son muy heterogéneas en las distintas facultadesespañolas. La próxima incorporación al espacio europeo deeducación superior, con la necesaria adecuación de losplanes de estudio, comportará una mejor definición de loscontenidos y objetivos docentes de esta materia. El últimodocumento de la Conferencia de Decanos de Facultades deMedicina identifica claramente la asignatura de patologíainfecciosa y la sitúa en el módulo de patologías médicasdentro del bloque de formación clínica humana. En nuestraopinión, la patología infecciosa debe plantearse como unaasignatura troncal situada preferentemente en el segundosemestre del quinto curso y disponer de un mínimo de 6 yun máximo de 9 créditos ECTS, entre teóricos y prácticos,distribuidos equitativamente en créditos presenciales,semipresenciales y de formación autónoma. La asignaturadebe tener una integración horizontal con la mayoría deasignaturas que conforman el bloque clínico y unaintegración vertical con la asignatura de microbiología. Lacoordinación de la asignatura y la impartición de la mayorparte de los créditos deben corresponder a especialistascon actividad clínica en enfermedades infecciosas(AU)

The teaching of the infectious diseases in the Bachelor ofMedicine degree consists of activities aimed at providingthe student with levels of competence in this area(knowledge, abilities, attitudes) appropriate for a generalphysician, and to give them a solid base to achieve theskills and abilities for becoming a specialist in this area.Currently, the location, the amount and quality ofinfectious diseases studies in the Bachelor of Medicinedegree are very disparate between the different SpanishMedical Schools. The incorporation into the EuropeanHigher Education Area, with the necessary adaptation ofcurricula, will enable the contents and the teachingobjectives in this field to be better defined. The latestdocument from the Medical Schools Deans Conferenceclearly identifies the studies of the infectious diseases intothe Medical Diseases module and in the area of humanclinical training. In our opinion, infectious diseases must beconsidered as a major subject, preferably in the secondsemester of the fifth year, and having a minimum of 6 anda maximum of 9 ECTS, theoretical and practical,distributed equally among attendance, part-attendanceand self-teaching credits. Infectious diseases pathologymust be horizontally integrated with most of the othersubjects in the clinical module and vertically integratedwith the subject of microbiology. The coordination andmost of the teaching of the credits in the infectiousdiseases subject must be done by specialists with clinicalactivity in infectious diseases(AU)

[Teaching of infectious diseases in medical degree studies]. / La docencia de la patología infecciosa en los estudios de grado de medicina.

The teaching of the infectious diseases in the Bachelor of Medicine degree consists of activities aimed at providing the student with levels of competence in this area (knowledge, abilities, attitudes) appropriate for a general physician, and to give them a solid base to achieve the skills and abilities for becoming a specialist in this area. Currently, the location, the amount and quality of infectious diseases studies in the Bachelor of Medicine degree are very disparate between the different Spanish Medical Schools. The incorporation into the European Higher Education Area, with the necessary adaptation of curricula, will enable the contents and the teaching objectives in this field to be better defined. The latest document from the Medical Schools Deans Conference clearly identifies the studies of the infectious diseases into the Medical Diseases module and in the area of human clinical training. In our opinion, infectious diseases must be considered as a major subject, preferably in the second semester of the fifth year, and having a minimum of 6 and a maximum of 9 ECTS, theoretical and practical, distributed equally among attendance, part-attendance and self-teaching credits. Infectious diseases pathology must be horizontally integrated with most of the other subjects in the clinical module and vertically integrated with the subject of microbiology. The coordination and most of the teaching of the credits in the infectious diseases subject must be done by specialists with clinical activity in infectious diseases.