13 results
Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC
- Victor Daniel Rosenthal, Ruijie Yin, Eric Christopher Brown, Brandon Hochahn Lee, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Prasad Rajhans, Yatin Mehta, Subhash Kumar Todi, Sushmita Basu, Suneeta Sahu, Shakti Bedanta Mishra, Rajesh Chawla, Pravin K. Nair, Rajalakshmi Arjun, Deepak Singla, Kavita Sandhu, Vijayanand Palaniswamy, Arpita Bhakta, Mohd-Basri Mat Nor, Tai Chian-Wern, Ider Bat-Erdene, Subhash P. Acharya, Aamer Ikram, Nellie Tumu, Lili Tao, Gustavo Andres Alvarez, Sandra Liliana Valderrama-Beltran, Luisa Fernanda Jiménez-Alvarez, Claudia Milena Henao-Rodas, Katherine Gomez, Lina Alejandra Aguilar-Moreno, Yuliana Andrea Cano-Medina, Maria Adelia Zuniga-Chavarria, Guadalupe Aguirre-Avalos, Alejandro Sassoe-Gonzalez, Mary Cruz Aleman-Bocanegra, Blanca Estela Hernandez-Chena, Maria Isabel Villegas-Mota, Daisy Aguilar-de-Moros, Alex Castañeda-Sabogal, Eduardo Alexandrino Medeiros, Lourdes Dueñas, Nilton Yhuri Carreazo, Estuardo Salgado, Safaa Abdulaziz-Alkhawaja, Hala Mounir Agha, Amani Ali El-Kholy, Mohammad Abdellatif Daboor, Ertugrul Guclu, Oguz Dursun, Iftihar Koksal, Merve Havan, Suna Secil Ozturk-Deniz, Dincer Yildizdas, Emel Okulu, Abeer Aly Omar, Ziad A. Memish, Jarosław Janc, Sona Hlinkova, Wieslawa Duszynska, George Horhat-Florin, Lul Raka, Michael M. Petrov, Zhilin Jin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 5 / May 2024
- Published online by Cambridge University Press:
- 04 January 2024, pp. 567-575
- Print publication:
- May 2024
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Objective:
To identify urinary catheter (UC)–associated urinary tract infection (CAUTI) incidence and risk factors.
Design:A prospective cohort study.
Setting:The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
Participants:The study included 169,036 patients, hospitalized for 1,166,593 patient days.
Methods:Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression.
Results:Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower–middle-income countries (3.05); and with patients in public hospitals (5.89).
The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P < .0001), female sex (aOR, 1.39; P < .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P < .0001), UC DU ratio (aOR, 1.09; P < .0001), public facilities (aOR, 2.24; P < .0001), and neurologic ICUs (aOR, 11.49; P < .0001).
Conclusions:CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.
Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
Multinational prospective study of incidence and risk factors for central-line–associated bloodstream infections in 728 intensive care units of 41 Asian, African, Eastern European, Latin American, and Middle Eastern countries over 24 years
- Victor Daniel Rosenthal, Ruijie Yin, Sheila Nainan Myatra, Ziad A. Memish, Camilla Rodrigues, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Majeda Afeef Al-Ruzzieh, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Yin Hoong Lai, Katherine Gomez, Daisy Aguilar-de-Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Tala Kardas, Michael M. Petrov, Asma Bouziri, Nguyen Viet-Hung, Vladislav Belskiy, Naheed Elahi, Estuardo Salgado, Zhilin Jin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 28 April 2023, pp. 1737-1747
- Print publication:
- November 2023
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Objective:
To identify central-line (CL)–associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs).
Design:From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms.
Setting:The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
Patients:In total, 278,241 patients followed during 1,815,043 patient days acquired 3,537 CLABSIs.
Methods:For the CLABSI rate, we used CL days as the denominator and the number of CLABSIs as the numerator. Using multiple logistic regression, outcomes are shown as adjusted odds ratios (aORs).
Results:The pooled CLABSI rate was 4.82 CLABSIs per 1,000 CL days, which is significantly higher than that reported by the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC NHSN). We analyzed 11 variables, and the following variables were independently and significantly associated with CLABSI: length of stay (LOS), risk increasing 3% daily (aOR, 1.03; 95% CI, 1.03–1.04; P < .0001), number of CL days, risk increasing 4% per CL day (aOR, 1.04; 95% CI, 1.03–1.04; P < .0001), surgical hospitalization (aOR, 1.12; 95% CI, 1.03–1.21; P < .0001), tracheostomy use (aOR, 1.52; 95% CI, 1.23–1.88; P < .0001), hospitalization at a publicly owned facility (aOR, 3.04; 95% CI, 2.31–4.01; P <.0001) or at a teaching hospital (aOR, 2.91; 95% CI, 2.22–3.83; P < .0001), hospitalization in a middle-income country (aOR, 2.41; 95% CI, 2.09–2.77; P < .0001). The ICU type with highest risk was adult oncology (aOR, 4.35; 95% CI, 3.11–6.09; P < .0001), followed by pediatric oncology (aOR, 2.51;95% CI, 1.57–3.99; P < .0001), and pediatric (aOR, 2.34; 95% CI, 1.81–3.01; P < .0001). The CL type with the highest risk was internal-jugular (aOR, 3.01; 95% CI, 2.71–3.33; P < .0001), followed by femoral (aOR, 2.29; 95% CI, 1.96–2.68; P < .0001). Peripherally inserted central catheter (PICC) was the CL with the lowest CLABSI risk (aOR, 1.48; 95% CI, 1.02–2.18; P = .04).
Conclusions:The following CLABSI risk factors are unlikely to change: country income level, facility ownership, hospitalization type, and ICU type. These findings suggest a focus on reducing LOS, CL days, and tracheostomy; using PICC instead of internal-jugular or femoral CL; and implementing evidence-based CLABSI prevention recommendations.
Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)
- Victor Daniel Rosenthal, Zhilin Jin, Ziad A. Memish, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Mohammad Abdellatif Daboor, Subhash Kumar Todi, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Mat Nor Mohd Basri, Katherine Gomez, Daisy Aguilar De Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Souad BelKebir, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Souha S. Kanj, Michael M. Petrov, Asma Bouziri, Nguyen Viet Hung, Vladislav Belskiy, Naheed Elahi, María Marcela Bovera, Ruijie Yin
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 09 January 2023, e6
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Objective:
Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs.
Design:Prospective cohort study.
Setting:This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries.
Participants:The study included patients admitted to ICUs across 24 years.
Results:In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16–1.28; P < .0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07–1.08; P < .0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23–1.31; P < .0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57–15.48; P < .0001); tracheostomy connected to a MV, which was associated with the next-highest risk (aOR, 8.31; 95% CI, 7.21–9.58; P < .0001); endotracheal tube connected to a MV (aOR, 6.76; 95% CI, 6.34–7.21; P < .0001); surgical hospitalization (aOR, 1.23; 95% CI, 1.17–1.29; P < .0001); admission to a public hospital (aOR, 1.59; 95% CI, 1.35-1.86; P < .0001); middle-income country (aOR, 1.22; 95% CI, 15–1.29; P < .0001); admission to an adult-oncology ICU, which was associated with the highest risk (aOR, 4.05; 95% CI, 3.22–5.09; P < .0001), admission to a neurologic ICU, which was associated with the next-highest risk (aOR, 2.48; 95% CI, 1.78–3.45; P < .0001); and admission to a respiratory ICU (aOR, 2.35; 95% CI, 1.79–3.07; P < .0001). Admission to a coronary ICU showed the lowest risk (aOR, 0.63; 95% CI, 0.51–0.77; P < .0001).
Conclusions:Some identified VAP RFs are unlikely to change: sex, hospitalization type, ICU type, facility ownership, and country income level. Based on our results, we recommend focusing on strategies to reduce LOS, to reduce the MV utilization ratio, to limit CPAP use and implementing a set of evidence-based VAP prevention recommendations.
Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections
- Victor Daniel Rosenthal, Zhilin Jin, Camilla Rodrigues, Sheila Nainan Myatra, Jigeeshu Vasishth Divatia, Sanjay K. Biswas, Anjana Mahesh Shrivastava, Mohit Kharbanda, Bikas Nag, Yatin Mehta, Smita Sarma, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Chin Seng Gan, Michelle Siu Yee Low, Marissa Bt Madzlan Kushairi, Soo Lin Chuah, Qi Yuee Wang, Rajesh Chawla, Aakanksha Chawla Jain, Sudha Kansal, Roseleen Kaur Bali, Rajalakshmi Arjun, Narangarav Davaadagva, Batsuren Bat-Erdene, Tsolmon Begzjav, Mat Nor Mohd Basri, Chian-Wern Tai, Pei-Chuen Lee, Swee-Fong Tang, Kavita Sandhu, Binesh Badyal, Ankush Arora, Deep Sengupta, Ruijie Yin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 8 / August 2023
- Published online by Cambridge University Press:
- 24 October 2022, pp. 1261-1266
- Print publication:
- August 2023
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Objective:
To identify risk factors for mortality in intensive care units (ICUs) in Asia.
Design:Prospective cohort study.
Setting:The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam.
Participants:Patients aged >18 years admitted to ICUs.
Results:In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line–associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001).
Conclusions:Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.
An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)
- Victor Daniel Rosenthal, Gustavo Jorge Chaparro, Eduardo Alexandrino Servolo-Medeiros, Dayana Souza-Fram, Daniela Vieira da Silva Escudero, Sandra Milena Gualtero-Trujillo, Rayo Morfin-Otero, Esteban Gonzalez-Diaz, Eduardo Rodriguez-Noriega, Miguel Angel Altuzar-Figueroa, Guadalupe Aguirre-Avalos, Julio César Mijangos-Méndez, Federico Corona-Jiménez, Blanca Estela Hernandez-Chena, Mohamed Rajab Abu-Jarad, Evelia Maria Diaz-Hernandez, María Guadalupe Miranda-Novales, José Guillermo Vázquez-Rosales, Daisy Aguilar-De-Morós, Elizabeth Castaño-Guerra, Gabriel Munoz-Gutierrez, Nepomuceno Mejia, Jenia Johana Acebo-Arcentales, Gabriela Di-Silvestre
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 42 / Issue 9 / September 2021
- Published online by Cambridge University Press:
- 14 January 2021, pp. 1098-1104
- Print publication:
- September 2021
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Background:
Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.
Methods:International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.
Results:In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).
The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.
Conclusions:Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings
- Víctor Daniel Rosenthal, Ider Bat-Erdene, Debkishore Gupta, Souad Belkebir, Prasad Rajhans, Farid Zand, Sheila Nainan Myatra, Majeda Afeef, Vito L. Tanzi, S. Muralidharan, Hail M. Al-Abdely, Amani El-Kholy, Safa A. Aziz AlKhawaja, Ali Pekcan Demiroz, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Amani F. Sayed, Estuardo Salgado-Yepez, Naheed Elahi, María del Rayo Morfin-Otero, Montri Luxsuwong, Braulio Matias De-Carvalho, Audrey Rose D. Tapang, Velmira Angelova Velinova, Ana Marcela Quesada-Mora, Tanja Anguseva, Aamer Ikram, Daisy Aguilar-de-Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di-Silvestre, Katarina Furova, May Osman Gamar-Elanbya, Umesh Gupta, Khalid Abidi, Lul Raka, Xiuqin Guo, Kushlani Jayatilleke, Najla Ben-Jaballah, Harrison Ronald Sandoval-Castillo, Andrew Trotter, Sandra L. Valderrama-Beltrán, Hakan Leblebicioglu, Humberto Guanche-Garcell, Miriam de Lourdes-Dueñas
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue 5 / May 2020
- Published online by Cambridge University Press:
- 18 March 2020, pp. 553-563
- Print publication:
- May 2020
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Background:
Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.
Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).
Conclusions:PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.
Impact of the International Nosocomial Infection Control Consortium (INICC)’s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina
- Victor Daniel Rosenthal, Javier Desse, Diego Marcelo Maurizi, Gustavo Jorge Chaparro, Pablo Wenceslao Orellano, Viviana Chediack, Rafael Cabrera, Daniel Golschmid, Cristina Graciela Silva, Julio Cesar Vimercati, Juan Pablo Stagnaro, Ivanna Perez, María Laura Spadaro, Adriana Miriam Montanini, Dina Pedersen, Teresa Laura Paniccia, Ana María Ríos Aguilera, Raul Cermesoni, Juan Ignacio Mele, Ernesto Alda, Analía Edith Paldoro, Agustín Román Ortta, Bettina Cooke, María Cecilia García, Mora Nair Obed, Cecilia Verónica Domínguez, Pablo Alejandro Saúl, María Cecilia Rodríguez del Valle, Alberto Claudio Bianchi, Gustavo Alvarez, Ricardo Pérez, Carolina Oyola
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 39 / Issue 4 / April 2018
- Published online by Cambridge University Press:
- 12 February 2018, pp. 445-451
- Print publication:
- April 2018
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OBJECTIVE
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.
DESIGNThis prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.
RESULTSDuring the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).
CONCLUSIONSImplementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.
Infect Control Hosp Epidemiol 2018;39:445–451
Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004–2013: Findings of the International Nosocomial Infection Control Consortium
- Yatin Mehta, Namita Jaggi, Victor Daniel Rosenthal, Maithili Kavathekar, Asmita Sakle, Nita Munshi, Murali Chakravarthy, Subhash Kumar Todi, Narinder Saini, Camilla Rodrigues, Karthikeya Varma, Rekha Dubey, Mohammad Mukhit Kazi, F. E. Udwadia, Sheila Nainan Myatra, Sweta Shah, Arpita Dwivedy, Anil Karlekar, Sanjeev Singh, Nagamani Sen, Kashmira Limaye-Joshi, Bala Ramachandran, Suneeta Sahu, Nirav Pandya, Purva Mathur, Samir Sahu, Suman P. Singh, Anil Kumar Bilolikar, Siva Kumar, Preeti Mehta, Vikram Padbidri, N. Gita, Saroj K. Patnaik, Thara Francis, Anup R. Warrier, S. Muralidharan, Pravin Kumar Nair, Vaibhavi R. Subhedar, Ramachadran Gopinath, Afzal Azim, Sanjeev Sood
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 37 / Issue 2 / February 2016
- Published online by Cambridge University Press:
- 26 November 2015, pp. 172-181
- Print publication:
- February 2016
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OBJECTIVE
To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.
METHODSSurveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.
RESULTSWe collected data from 236,700 ICU patients for 970,713 bed-days
Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days
In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days
Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP
Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs
Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.
CONCLUSIONSDespite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.
Infect. Control Hosp. Epidemiol. 2016;37(2):172–181
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Findings of the International Nosocomial Infection Control Consortium (INICC), Part III Effectiveness of a Multidimensional Infection Control Approach to Reduce Central Line—Associated Bloodstream Infections in the Neonatal Intensive Care Units of 4 Developing Countries
- Victor Daniel Rosenthal, Lourdes Dueñas, Martha Sobreyra-Oropeza, Khaldi Ammar, Josephine Anne Navoa-Ng, Ana Conceptión Bran de Casares, Lilian de Jesús Machuca, Nejla Ben-Jaballah, Asma Hamdi, Victoria D. Villanueva, María Corazon V. Tolentino
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 34 / Issue 3 / March 2013
- Published online by Cambridge University Press:
- 02 January 2015, pp. 229-237
- Print publication:
- March 2013
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Objective.
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce central line-associated bloodstream infection (CLABSI) rates.
Setting.Four neonatal intensive care units (NICUs) of INICC member hospitals from El Salvador, Mexico, Philippines, and Tunisia.
Patients.A total of 2,241 patients hospitalized in 4 NICUs for 40,045 bed-days.
Methods.We conducted a before-after prospective surveillance study. During Phase 1 we performed active surveillance, and during phase 2 the INICC multidimensional infection control approach was implemented, including the following practices: (1) central line care bundle, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CLABSI rates, and (6) performance feedback of infection control practices. We compared CLABSI rates obtained during the 2 phases. We calculated crude stratified rates, and, using random-effects Poisson regression to allow for clustering by ICU, we calculated the incidence rate ratio (IRR) for each follow-up time period compared with the 3-month baseline.
Results.During phase 1 we recorded 2,105 CL-days, and during phase 2 we recorded 17,117 CL-days. After implementation of the multidimensional approach, the CLABSI rate decreased by 55%, from 21.4 per 1,000 CL-days during phase 1 to 9.7 per 1,000 CL-days during phase 2 (rate ratio, 0.45 [95% confidence interval, 0.33–0.63]). The IRR was 0.53 during the 4–12-month period and 0.07 during the final period of the study (more than 45 months).
Conclusions.Implementation of a multidimensional infection control approach was associated with a significant reduction in CLABSI rates in NICUs.
Attributable Cost and Length of Stay for Patients With Central Venous Catheter—Associated Bloodstream Infection in Mexico City Intensive Care Units A Prospective, Matched Analysis
- Francisco Higuera, Manuel Sigfrido Rangel-Frausto, Victor Daniel Rosenthal, Jose Martinez Soto, Jorge Castañon, Guillermo Franco, Natividad Tabal-Galan, Javier Ruiz, Pablo Duarte, Nicholas Graves
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 28 / Issue 1 / January 2007
- Published online by Cambridge University Press:
- 02 January 2015, pp. 31-35
- Print publication:
- January 2007
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Background.
No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico.
Objective.To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City.
Design.An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI.
Setting.Adult ICUs in 3 hospitals in Mexico City.
Patients and Methods.A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments.
Results.For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was $598, the mean extra hospital cost was $11,591, and the attributable extra mortality was 20%.
Conclusions.In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.
Device-Associated Nosocomial Infection Rates in Intensive Care Units of Argentina
- Victor Daniel Rosenthal, Sandra Guzmán, Christopher Crnich
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 25 / Issue 3 / March 2004
- Published online by Cambridge University Press:
- 02 January 2015, pp. 251-255
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- March 2004
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Background:
Nosocomial infections are an important public health problem in many developing countries, particularly in the intensive care unit (ICU) setting. No previous data are available on the incidence of device-associated nosocomial infections in different types of ICUs in Argentina.
Methods:We performed a prospective nosocomial infection surveillance study during the first year of an infection control program in six Argentinean ICUs. Nosocomial infections were identified using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System definitions, and site-specific nosocomial infection rates were calculated.
Results:The rate of catheter-associated bloodstream infections in medical-surgical ICUs was 30.3 per 1,000 device days; it was 14.2 per 1,000 device-days in coronary care units (CCUs). The rate of ventilator-associated pneumonia in medical-surgical ICUs was 46.3 per 1,000 device-days; it was 45.5 per 1,000 device-days in CCUs. The rate of symptomatic catheter-associated urinary tract infections in medical-surgical ICUs was 18.5 per 1,000 device-days; it was 12.1 per 1,000 device-days in CCUs.
Conclusion:The high rate of nosocomial infections in Argentinean ICUs found during our surveillance suggests that ongoing targeted surveillance and implementation of proven infection control strategies is needed in developing countries such as Argentina.
Effect of Education and Performance Feedback on Rates of Catheter-Associated Urinary Tract Infection in Intensive Care Units in Argentina
- Victor Daniel Rosenthal, Sandra Guzman, Nasia Safdar
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 25 / Issue 1 / January 2004
- Published online by Cambridge University Press:
- 02 January 2015, pp. 47-50
- Print publication:
- January 2004
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Objective:
To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).
Setting:Two level III adult ICUs in a private healthcare facility in Argentina.
Patients:All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.
Methods:A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after imple-menting education and performance feedback.
Results:There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P<.0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI95, 0.39 to 0.86; P = .006).
Conclusion:Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.