<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0123-9392</journal-id>
<journal-title><![CDATA[Infectio]]></journal-title>
<abbrev-journal-title><![CDATA[Infect.]]></abbrev-journal-title>
<issn>0123-9392</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Infectología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0123-93922017000200088</article-id>
<article-id pub-id-type="doi">10.1016/j.infect.2016.04.002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Evaluación de la herramienta SaTScan-Whonet para la detección precoz de brotes en infecciones bacterianas en una institución de tercer nivel de atención en Colombia]]></article-title>
<article-title xml:lang="en"><![CDATA[Evaluation of the SaTScan-Whonet tool for detecting outbreaks of bacterial infection in a tertiary healthcare institution in Colombia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Meneses-Ríos]]></surname>
<given-names><![CDATA[Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monsalve-Londoño]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[Aura Lucía Leal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gamboa]]></surname>
<given-names><![CDATA[Óscar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valderrama-Beltrán]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Linares-Miranda]]></surname>
<given-names><![CDATA[Claudia Janeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la Sabana Departamento de Medicina Interna ]]></institution>
<addr-line><![CDATA[Chía ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Colombia Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la Sabana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Chía ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario San Ignacio  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>21</volume>
<numero>2</numero>
<fpage>88</fpage>
<lpage>95</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0123-93922017000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0123-93922017000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0123-93922017000200088&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  Las infecciones asociadas al cuidado de la salud representan un problema de salud pública y la transmisión horizontal supone un incremento en la morbimortalidad y los costos en la atención. La vigilancia activa es costosa y tiene alto riesgo de omitir la detección de brotes, mientras que la virtual (modelos matemáticos) permite la búsqueda sistemática de alertas de brotes. El objetivo de este estudio es evaluar la relación costo-efectividad del uso de la herramienta SaTScan-Whonet para la detección temprana de infecciones bacterianas, comparada con la vigilancia tradicional en una institución de alta complejidad de Colombia.  Metodología:  En un hospital universitario de alta complejidad se realizó un estudio retrospectivo, se identificó un brote bacteriano, se caracterizó clínicamente y por biología molecular. Se extrajeron las bases de datos de los sistemas automatizados de identificación y susceptibilidad microbiológica. Se realizaron análisis retrospectivos de SaTScan-Whonet, así como simulaciones diarias para el primer semestre de 2011 de manera prospectiva; también se identificó la fecha para la alerta de detección de brote, tanto en la vigilancia activa como en la virtual.  Resultados:  Se aislaron 4.584 microorganismos en los servicios de hospitalización tanto UCI como no UCI entre 2010 y 2011 (2.288 y 2.296 respectivamente). Por vigilancia activa se notificó un brote por Enterococcus faecium el 28 de marzo de 2011, que fue caracterizado por biología molecular con la presencia del gen Van A, que confiere resistencia a glucopéptidos. Se identificó de manera retrospectiva una alerta de brote para E. faecium entre el 14 de marzo y el 10 de mayo de 2011 con un intervalo de recurrencia de 609.384. En los análisis prospectivos simulados se identificó la primera alerta de brote de esta bacteria el 13 de abril de 2011 con un intervalo de recurrencia de 3.897 (p = 0,0002655).  Conclusión:  La utilización de dicha herramienta de manera prospectiva no fue superior a la vigilancia activa en cuanto a oportunidad en la detección. Los análisis retrospectivos tuvieron un alto rendimiento diagnóstico y podrían ser de utilidad para los sistemas de vigilancia y control de los entes reguladores.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  Healthcare-associated infections represent a public health problem, and horizontal transmission has led to an increase in morbidity and mortality as well as higher health care costs. Active surveillance is expensive and carries high risk of failing to detect outbreaks. Virtual surveillance (mathematical models) allows a systematic search for alerts to outbreaks. The objective of this study is to evaluate the cost-effectiveness of the SaTScan-Whonet tool for the early detection of outbreaks of bacterial infection, compared with traditional surveillance, in an institution of high complexity in Colombia.  Methodology:  In a university hospital of high complexity a retrospective study was performed, identifying a bacterial outbreak that was characterised clinically and by molecular biology techniques. Databases of automated systems of identification and microbiological susceptibility were extracted. Retrospective analyses were performed using SaTScan-Whonet and daily simulations during the first semester of 2011 in a prospective manner. The date for the alert to the detection of the outbreak for both active and virtual surveillance was also identified.  Results:  A total of 4,584 microorganisms were isolated both inside and outside the ICU bet-ween 2010 and 2011 (2,288 and 2,296, respectively). An outbreak of Enterococcus faecium was identified by active surveillance on March 28, 2011. Using molecular biology techniques, the outbreak was characterised, showing the presence of the vanA gene, which confers resistance to glycopeptides. An alert to an Enterococcus faecium outbreak was retrospectively identified between March 14 and May 10, 2011 with a recurrence interval of 609,384. The first alert to outbreak for this bacterium was identified in a prospective simulated analysis on April 13, 2011 with a recurrence interval of 3,897 (P=.0002655).  Conclusion:  The use of such a tool prospectively is not superior to active surveillance in regard to timely detection of bacterial outbreaks. Retrospective analyses have high diagnostic ability and could be very helpful in systems of surveillance and control of regulatory entities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Resistencia antibacteriana]]></kwd>
<kwd lng="es"><![CDATA[Detección de brotes]]></kwd>
<kwd lng="es"><![CDATA[Whone]]></kwd>
<kwd lng="en"><![CDATA[Antimicrobial resistance]]></kwd>
<kwd lng="en"><![CDATA[Outbreak detection]]></kwd>
<kwd lng="en"><![CDATA[Whonet]]></kwd>
</kwd-group>
</article-meta>
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