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Objective: The CoVIDA project is a public-private collaboration led by Universidad de los Andes that contributed to the SARS-CoV-2 epidemiological surveillance in Bogota and nearby municipalities. We aimed to describe the development and performance of the Drive/Walk-through free RT- PCR for SARS-CoV-2 testing strategy implemented by CoVIDA. Material and method: We performed a descriptive analysis of the characteristics and performance of the CoVIDA Drive/Walk-through testing centers. The model and the process indicators to assess the model’s performance were based on international experiences and scientific literature. Two screening centers were implemented in shopping centers in the north and south of Bogota. We reported the number of tests taken, the number of positive tests, and the number of participants that used the model by the type of occupations. Results: In total, 36,689 nasopharyngeal RT-PCR tests for SARS-CoV-2 were performed with a 5.75% cumulative positivity. Process indicators showed an excellent performance and an important contribution in reducing barriers to access to testing. Conclusions: the CoVIDA Drive/Walk-through testing centers supported the epidemiological surveillance in asymptomatic or mild-symptomatic population in Bogota. Low and middle-income countries can use this model as a cost-effective and innovative solution strategy to intensify testing and help mitigate the pandemic.

ResumenUn número creciente de pacientes críticamente enfermos son atendidos por sepsis secundaria a infecciones bacterianas o micóticas. En este grupo de pacientes la sepsis per se es un factor de riesgo para el desarrollo de falla renal, la cual implica un mayor riesgo de mortalidad. Un panel de expertos en las áreas de infectología, cuidado crítico y nefrología prepararon un consenso basado en la información actual (“evidencia”) sobre el uso de antimicrobianos (antibióticos y antifúngicos) en pacientes críticamente enfermos con falla renal o en riesgo de padecerla. Se identificó la literatura científica relevante mediante un proceso de búsqueda sistemática y se generaron recomendaciones por medio del método presencial Delphi. Se propone que las recomendaciones de este consenso sean utilizadas por los trabajadores de la salud que manejen este grupo de pacientes, con el fin de identificar aquellos en mayor riesgo de progresión a falla renal y establecer las estrategias terapéuticas que tengan el mayor beneficio con la menor probabildad de efectos secundarios serios sobre la función renal. Se adicionó una estrategia para la implmentación de estas recomendaciones.AbstractA growing number of critically ill patients are being taken care with sepsis secondary to bacterial or mycotic infections. In this group of patients, sepsis per se is a risk factor for the development of renal failure, which has been related to an increased risk of hospital mortality. An expert panel in infectious diseases, critical care and renal diseases prepared an evidence based consensus over the use of antimicrobials (antibacterial and antifungal agents) in critically ill patients with renal failure or at risk of suffering it. A sytematic review of the scientific literature was performed and recommendations were established by means of a consensus using the Delphi method. Recommendations proposed by this consensus are intended to be use by healthcare workers who are in charge of this kind of patients with the aim to identify the group of patients with higher risk of developing renal failure and to establish the therapeutic measures theat have the best outcome and lower frequency of severe side effects in renal function. An implementation strategy was added with the recommendations.

ResumenStaphylococcus aureus es una de los principales causas de infección de pacientes en estado crítico. La información de vigilancia muestra 32, 9% de resistencia a la meticilina y una frecuencia de aislamiento como causante de infección de 12, 15% en las unidades de cuidados intensivos, especialmente infecciones del torrente sanguíneo. No se encontraron artículos de síntesis de de los datos sobre el impacto de la resistencia de esta bacteria en la mortalidad de los pacientes gravemente comprometidos. Esta revisión de la literatura resume los estudios de pronóstico sobre la infección del torrente sanguíneo por S. aureus resistente a meticilina (SARM) en pacientes de la unidad de cuidados intensivos. Se incluyeron los artículos que evaluaron la mortalidad por bacteriemias primarias o secundarias, comparándola con controles sensibles a la meticilina o infectados por otra bacteria. No se incluyeron estudios con bacteriemias polimicrobianas. De 387 referencias, seis estudios cumplieron los criterios de inclusión. Los datos disponibles no permiten generar una conclusión sobre la mortalidad relacionada con SARM en la unidad de cuidados intensivos. Los análisis bivariados muestran un incremento de la mortalidad, el cual tiende a desaparecer cuando se controla por otras variables, como el tratamiento inicial apropiado y la gravedad del cuadro clínico. La participación de este microorganismo en la mortalidad de pacientes de la unidad de cuidados intensivos y sus determinantes, permanecen aún sin explicar.SummaryStaphylococcus aureus is an important infectious pathogen in critically ill patients. Local surveillance shows its isolation as infectious causative pathogen at intensive care units in 12.15% of cases and a methicillin resistance rate of 32.9%, specially related with bloodstream infections. This review summarizes available prognosis studies related to methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at intensive care unit (ICU). References with primary or secondary bacteremia patients compared with susceptible pathogen controls or different pathogen were included. Polymicrobial bacteremias were not included. 387 references were retrieved, only six studies met the inclusion criteria. The available evidence does not support a definitive conclusion about MRSA-related mortality in ICU. Increased mortality registered in bivariate analysis disappears when other covariates as appropriate initial therapy and baseline severity are adjusted. The involvement of this marker in ICU patient's mortality and their prognosis determinants still remain unexplained.