RESUMEN Objetivo. Evaluar el cumplimiento de los hospitales de segundo y tercer nivel en la presentación mensual de información sobre el consumo de antibióticos en el Sistema Nacional de Vigilancia en Salud Pública de Colombia (SIVIGILA-INS) y describir el consumo de antibióticos reportado en el período 2018-2020. Métodos. Este estudio incluyó un análisis secundario de los datos del consumo de antibióticos reportado en SIVIGILA-INS. Se evaluó la frecuencia de los informes hospitalarios y se comparó con los informes esperados, desglosados por unidad de cuidados intensivos (UCI) y otros servicios distintos a la UCI, y por región geográfica. El consumo se expresó en dosis diaria definida (DDD) por 100 camas ocupadas para siete antibióticos. Resultados. Más del 70% de los hospitales notificaron el consumo de antibióticos al menos una vez en cada uno de los tres años (79% en la UCI y 71% en los servicios distintos a la UCI). De estos, el 59% de las UCI completaron los informes mensuales (12 informes en un año) entre el 2018 y el 2019, pero solo el 4% en el 2020. El 52% de los servicios distintos a la UCI completó los informes en el 2019 y el 2% en el 2020. En la mayoría de las regiones hubo una disminución general de la notificación en el 2020. El análisis del consumo de antibióticos mostró un aumento de piperacilina/tazobactam, ertapenem y cefepima del 2019 al 2020. Conclusiones. Se encontraron disparidades en la coherencia y en la frecuencia de la presentación de informes. Es necesario destinar esfuerzos para mejorar el cumplimiento de la notificación mensual, que disminuyó en el 2020 posiblemente debido a la pandemia de COVID-19. La falta de cumplimiento en la presentación de los reportes y los problemas de calidad de los datos deben abordarse con los hospitales para facilitar la interpretación válida de las tendencias de consumo de antibióticos.

RESUMO Objetivo. Avaliar o cumprimento da exigência de notificar mensalmente o consumo de antibióticos em hospitais secundários e terciários ao Sistema Nacional de Vigilância em Saúde Pública da Colômbia (SIVIGILA-INS) e descrever o consumo informado de antibióticos de 2018 a 2020. Métodos. Este estudo envolveu uma análise secundária dos dados de consumo de antibióticos enviados para o SIVIGILA-INS. A frequência de notificação pelos hospitais foi avaliada e comparada com a frequência esperada. Os dados foram desagregados entre unidades de terapia intensiva (UTIs) e enfermarias gerais e por regiões geográficas. O consumo foi expresso como dose diária definida (DDD) por 100 leitos ocupados para sete antibióticos. Resultados. Mais de 70% dos hospitais notificaram consumo de antibióticos pelo menos uma vez em cada um dos três anos (79% na UTI e 71% nas enfermarias gerais). Entre eles, 59% dos hospitais enviaram todas as notificações relativas a UTIs (12 notificações mensais) no período de 2018 a 2019, mas apenas 4% o fizeram em 2020. No caso das enfermarias gerais, 52% dos hospitais enviaram todas as notificações em 2019 e 2% o fizeram em 2020. A maioria das regiões teve uma diminuição geral no número de notificações enviadas em 2020. A análise do consumo de antibióticos revelou um aumento no uso de piperacilina/tazobactam, ertapeném e cefepima de 2019 para 2020. Conclusões. Houve lacunas na uniformidade e frequência das notificações. São necessários esforços para melhorar o cumprimento da exigência de notificações mensais, que, possivelmente devido à pandemia de COVID‑19, diminuiu em 2020. Problemas relacionados ao não cumprimento da exigência de notificação e à qualidade dos dados devem ser resolvidos junto aos hospitais para permitir uma interpretação válida das tendências de consumo de antibióticos.

ABSTRACT Objective. To assess the compliance in secondary and tertiary level hospitals with monthly reporting of antibiotic consumption to the Colombian National Public Health Surveillance System (SIVIGILA-INS), and to describe reported antibiotic consumption during 2018–2020. Methods. This study involved a secondary analysis of antibiotic consumption data reported to SIVIGILA-INS. Frequency of hospital reporting was assessed and compared against expected reports, disaggregated by intensive care units (ICU)/non-ICU wards and geographical regions. Consumption was expressed as defined daily dose (DDD) per 100 occupied beds for seven antibiotics. Results. More than 70% of hospitals reported antibiotic consumption at least once in each of the three years (79% in ICU and 71% in non-ICU wards). Of these, ICU monthly reporting was complete (12 monthly reports per year) for 59% in the period 2018–2019 but only 4% in 2020. Non-ICU reporting was complete for 52% in 2019 and for 2% in 2020. Most regions had an overall decrease in reporting in 2020. Analysis of antibiotic consumption showed an increase for piperacillin/tazobactam, ertapenem, and cefepime from 2019 to 2020. Conclusions. There were gaps in the consistency and frequency of reporting. Efforts are needed to improve compliance with monthly reporting, which declined in 2020, possibly due to the COVID-19 pandemic. Non-compliance on reporting and data quality issues should be addressed with the hospitals to enable valid interpretation of antibiotic consumption trends.

Lung transplantation is a valid therapeutic option to prolong survival in patients with end-stage pulmonary disease. Survival after lung transplantation has greatly improved as a result of advances in surgical techniques, careful preservation of donor organs, progress in immunosuppressive therapy, and the use of imaging techniques for an early recognition of complications. Our goal is to provide a radiology guide of acute and chronic rejection of lung transplants. The fndings of multidetector computed tomography (MDCT) studies are described.

El trasplante pulmonar es una opción terapéutica válida para mejorar la sobrevida de pacientes con enfermedades respiratorias en fase avanzada. La supervivencia tras el trasplante de pulmón ha mejorado en gran medida como resultado de los avances en la técnica quirúrgica, la cuidadosa preservación de órganos de donantes, las mejoras en la terapia inmunosupresora y el reconocimiento precoz de complicaciones con el uso de técnicas de imagen. Nuestro objetivo es proporcionar una guía radiológica del rechazo agudo y crónico del trasplante pulmonar. Se describirán los hallazgos por tomografía computada multidetector (TCMD).

Objective: To identify the factors determining the underestimation of the actual weight of the children by the father and mother of preschooler users of Children's homes (CH) of the Colombian Family Welfare Institute located in the municipality of Floridablanca, Colombia. Subjects and Methods: A cross-sectional study was done in a random sample of 186 preschool children aged 3-6 years from 7 Floridablanca's CH. Researchers interviewed parents and measured weight and height of children, parents, and caregivers. The analysis was conducted by way of single and multiple binomial regression models. Results: Underestimating the weight of the children was 44.6%, 46.3%, 45% and 44.2% for the mother, father, grandparents and uncles, respectively. The underestimation was associated with the child' sex (mother: 1.59 95% CI 1.11-2.29 RP; father: PR2.00 95% CI 1.1-3.6), education (PR 1.42 95 1.05-1.92%), occupation (PR 1.05 95% CI 1.05-1.05) and obesity's history in the mother (PR 1.51 95% CI 1.10-2.08) and the current weight of the father (PR 2.31 95% CI 1.1 to 5.0). Conclusions: A high proportion of families of children do not perceive overweight and obesity. Issues such as the child's sex, occupation and education of the mother and obesity in both parents must be considered when we will educate parents on the recognition of obesity as a public health problem.

Objetivo: Identificar los factores determinantes de la subestimación del peso real de los niños por parte del padre y la madre de preescolares usuarios del programa de Hogares Infantiles (HI) del Instituto Colombiano de Bienestar Familiar (ICBF) localizados en el municipio de Floridablanca, Colombia. Sujetos y métodos. Se realizó un estudio de corte transversal en una muestra aleatoria de 186 preescolares de 3 a 6 años de 7 HI de Floridablanca. Se entrevistaron a los padres o cuidadores y se midió la talla de los niños, padres y cuidadores. El análisis se realizó mediante modelos de regresión binomial simple y múltiple. Resultados: La subestimación del peso de los niños fue de 44,6 %, 46,3 % 45 %, y 44,2 % para la madre, el padre, los abuelos y los tíos, respectivamente. La subestimación se asoció al sexo del niño (madre: RP 1,59 IC95 % 1,11-2,29; padre: RP 2,00 IC95 % 1,1-3,6), la escolaridad (RP 1,42 IC95% 1,05-1,92), ocupación (1,05 IC95 % 1,05-1,05) y antecedentes de obesidad de la madre (RP 1,51 IC95% 1,102,08) y con el peso actual del padre (RP 2,31 IC95% 1,1-5,0). Conclusiones: El sobrepeso y la obesidad no son percibidos por un elevado porcentaje de familiares de los niños. Aspectos como el sexo del niño, la ocupación y escolaridad de la madre y obesidad en ambos padres deben considerarse al momento de educar a los padres sobre el reconocimiento de la obesidad como un problema en salud pública.

Several cases of Candida bloodstream infections were documented from June to October 2004 at a tertiary care center in Bogotá, Colombia. Since no cases of candidemia had occurred during the preceding four months, an outbreak was declared. As a result, a microbiological study, a revision of infection control practices and a case-control study were performed. In all, 18 cases of candidemia were ascertained. Parenteral nutrition (p=0.04), presence of a central line (p=0.03), and severity of illness (p=0.03) were associated with candidemia in bivariate analysis. Diverse Candida species were observed. Candida parapsilosis contamination was found in plastic containers used for transient intravenous (IV) medication storage at the bedside, plastic bags reused for the transportation of IV medicines and cotton used for disinfection of IV ports. Poor infection control practices were widely observed. The outbreak was controlled after elimination of plastic bags used for transportation, instauration of daily disinfection of IV medication containers, acquisition of sterile alcohol swabs for port disinfection and staff education. It was concluded that candidemia was associated with previously-described risk factors and that poor infection-control practices were likely responsible for the outbreak.