P-378. Benchmarking Healthcare-Associated Infections in Developing Countries Post-COVID-19: From High-Resource Hospitals in Southwest Brazil to Remote Hospitals in Jungle Regions
Authors: Couto Bráulio R G M , Starling Carlos E , Pereira Hoberdan , Silva Estevão Urbano , Ladeira Ana Paula , Souza Rossana , Bentes Aline , De Souza Bruna , Araújo Camila , De Jesus Cinthia Carolini , De Oliveira Claudia M , Pereira Daniela , Pereira Diene , Silva Dilma , Munefiça Eder , Vieira Emilly , Mattos Junior Ewaldo , De Paula Felipe , Carvalho Fernando , Pereira Graziela , Souza Guenael Freire , da Cruz Guilherme , Dourado Hellen , Fernandes herbert , Castro Isabela , Versiani Karina , Cristina Góis Louranny , Silveira Luana , Covello Luciana , Fernandes Luciano , Esteves Marcelo , Clara Bueno Maria , Melo Mariana , Sampaio Raynara , Valadares Shirley , Pereira Tereza , Couto Thaís , Andrade Virginia , Carvalho Walisson Ferreira , Lima Naísses Zóia 
Published: January 2025

Abstract

Background
Benchmarking is essential for evaluating healthcare quality. In Brazil, few studies on healthcare-associated infections (HAIs) exist, and most focus on internal benchmarking within specific populations, creating a gap in understanding broader regions. Applying benchmarks from high-resource countries to low-resource settings can produce misleading conclusions due to differing healthcare environments. Thus, it's crucial to refine external benchmarks tailored to developing countries.Figure 1Pooled mean and percentiles (10th, 25th, 50th, 75th, and 90th) for seven indicators related to overall and hemodialysis outcomes.

Methods
The majority of hospitals involved in this study use SACIH+, a hospital infection control software (www.biobytebrasil.com), which compiles data from various Brazilian hospitals. All hospitals followed prospective surveillance protocols for healthcare-associated infections (HAIs) in accordance with the NHSN/CDC guidelines.
Benchmarks for HAIs were established for different categories: Medical/Surgical Intensive Care Unit (ICU) HAI rates, surgical site infections, and hospital-wide HAI rates. These benchmarks were defined as the 10th and 90th percentiles using data collected from 25 hospitals between 2021 and 2023. While not all benchmarks included data from every hospital, each benchmark represents data from at least three hospitals and a minimum denominator of 20.Figure 2Pooled mean and percentiles (10th, 25th, 50th, 75th, and 90th) for 21 indicators from Medical/Surgical Adult ICU, Pediatric ICU, and Neonatal ICU.

Results
Seven overall and hemodialysis rates were benchmarked (Fig. 1). We included lethality rate and global HAI risk (covering all infection sites) as they are required HAI indicators in Brazil. Figure 2 shows benchmarks for key indicators in Adult Medical/Surgical ICU, Pediatric ICU, and Neonatal ICU. Surgical site infection rates, overall and by surgical service, and for major surgical procedures, are detailed in Figures 3 and 4.Figure 3Pooled mean and percentiles (10th, 25th, 50th, 75th, and 90th) for 19 overall surgical site infection rates, stratified by service and wound classification (clean, clean-contaminated, contaminated, and infected).

Conclusion
This study provides a comprehensive summary of benchmarks for 95 key HAI rates applicable to Brazil in the post-COVID-19 era and other developing countries. By offering external benchmarks across diverse settings, including high-resource and remote hospitals, these findings can guide healthcare facilities in improving infection control practices and refining surveillance protocols. Ultimately, the established benchmarks offer a valuable resource for hospitals striving to enhance patient safety and optimize infection control measures globally.Figure 4Pooled mean and percentiles (10th, 25th, 50th, 75th, and 90th) for surgical site infections across 48 different surgical procedures.

Disclosures
All Authors: No reported disclosures