STRUCTURING OF HOSPITAL INFECTION CONTROL COMMITTEES AND THE BACTERIAL RESISTANCE RATE IN BRAZILIAN HOSPITALS: A MULTICENTER CROSS-SECTIONAL STUDY

The structure of the Hospital Infection Control Committee (HICC) may influence infection outcomes, but this relationship is still poorly understood. This study sought to associate HICC infrastructure with infection control indicators. Multicenter cross-sectional study conducted in 11 Brazilian hospitals, classified according to complexity, number of beds, and number of ICU beds. HICC structure and processes were evaluated according to World Health Organization (WHO) criteria, team composition, existence of action plans, infection indicators, and bacterial resistance profile. The mean number of professionals in the HICC was 2.36 (min: 1; max: 6), all in adequate number. All had a program and action plan; 10 had their own laboratory. Epidemiological surveillance was performed by all, being global in 54.54%. In 2024, the mean VAP rate was 7.9/1,000 ventilator-days; CLABSI was 2.4/1,000 CVC-days; and CAUTI was 2.1/1,000 urinary catheter-days. Prevention bundles were used in 81.8% of hospitals, with adherence of: 54.9% (VAP prevention), 69.7% (CVC insertion), 42.1% (CVC maintenance), 50.3% (urinary catheter insertion), and 39.5% (urinary catheter maintenance). Hand hygiene adherence in ICUs was 46.1%, and mean alcohol gel consumption was 28.4 mL/patient-day. HICC audits were performed by 63.63% of hospitals and antimicrobial audits by 54.54%. Hospitals were divided into three clusters, with the following associated features: WHO score, adherence to the CVC maintenance bundle, monitoring and adherence to hand hygiene, and alcohol consumption. Cluster 2 had a higher WHO score (median: 705; P25: 695.0; P75: 713.75) than clusters 1 (525; P25: 493.75; P75: 531.25) and 3 (537; P25: 530.0; P75: 537.50). From Jan–Dec/2024, 5,305 bacteriological tests were performed. The rate of oxacillin-resistant staphylococci was 25.2% in cluster 2 and 23.6% in the others; carbapenem resistance was 26.9% (cluster 2) and 25.9% (others). In hospitals with antimicrobial audits, the MRSA rate was 20.9% vs. 20.7% and carbapenem resistance 27.4% vs. 22.2%. When alcohol consumption was >30 mL/patient-day, the MRSA rate was 16.9% vs. 26.2%; carbapenem resistance was 26.18% in both. Bacterial resistance is multifactorial and involves patient characteristics, hospital characteristics, community factors, and temporal aspects. In this study, no direct correlation was observed between HICC infrastructure and reduced bacterial resistance.