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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

Published online by Cambridge University Press:  12 February 2018

Victor Daniel Rosenthal ,
Javier Desse ,
Diego Marcelo Maurizi ,
Gustavo Jorge Chaparro ,
Pablo Wenceslao Orellano ,
Viviana Chediack ,
Rafael Cabrera ,
Daniel Golschmid ,
Cristina Graciela Silva  and
Julio Cesar Vimercati
...Show all authors
Victor Daniel Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Javier Desse
Affiliation:
Sanatorio San Cayetano, Buenos Aires, Argentina 3Hospital E F Erill, Escobar, Argentina
Diego Marcelo Maurizi
Affiliation:
Hospital Municipal De Agudos Dr Leónidas Lucero, Bahía Blanca, Argentina Hospital Privado del Sur, Bahía Blanca, Argentina
Gustavo Jorge Chaparro
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
Pablo Wenceslao Orellano
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina Universidad Tecnológica Nacional, Facultad Regional San Nicolás and Consejo Nacional de Investigaciones Científicas y Técnicas, San Nicolás, Argentina
Viviana Chediack
Affiliation:
Policlínico Central Unión Obrera Metalúrgica, Buenos Aires, Argentina
Rafael Cabrera
Affiliation:
3Hospital E F Erill, Escobar, Argentina
Daniel Golschmid
Affiliation:
Hospital Privado Raul Matera, Bahía Blanca, Argentina
Cristina Graciela Silva
Affiliation:
Sanatorio Privado, Buenos Aires, Argentina
Julio Cesar Vimercati
Affiliation:
Hospital Zonal General de Agudos Dr Ricardo Gutiérrez, La Plata, Argentina
Juan Pablo Stagnaro
Affiliation:
Instituto Central de Medicina, La Plata, Argentina
Ivanna Perez
Affiliation:
Sanatorio San Cayetano, Buenos Aires, Argentina
María Laura Spadaro
Affiliation:
Hospital Municipal De Agudos Dr Leónidas Lucero, Bahía Blanca, Argentina Hospital Privado Raul Matera, Bahía Blanca, Argentina
Adriana Miriam Montanini
Affiliation:
Hospital Municipal De Agudos Dr Leónidas Lucero, Bahía Blanca, Argentina
Dina Pedersen
Affiliation:
Hospital Municipal De Agudos Dr Leónidas Lucero, Bahía Blanca, Argentina
Teresa Laura Paniccia
Affiliation:
Hospital Municipal De Agudos Dr Leónidas Lucero, Bahía Blanca, Argentina
Ana María Ríos Aguilera
Affiliation:
Hospital Privado del Sur, Bahía Blanca, Argentina
Raul Cermesoni
Affiliation:
Hospital Privado del Sur, Bahía Blanca, Argentina
Juan Ignacio Mele
Affiliation:
Hospital Privado del Sur, Bahía Blanca, Argentina
Ernesto Alda
Affiliation:
Hospital Privado del Sur, Bahía Blanca, Argentina
Analía Edith Paldoro
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
Agustín Román Ortta
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
Bettina Cooke
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
María Cecilia García
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
Mora Nair Obed
Affiliation:
Instituto Médico Platense SA, La Plata, Argentina
Cecilia Verónica Domínguez
Affiliation:
Policlínico Central Unión Obrera Metalúrgica, Buenos Aires, Argentina
Pablo Alejandro Saúl
Affiliation:
Policlínico Central Unión Obrera Metalúrgica, Buenos Aires, Argentina
María Cecilia Rodríguez del Valle
Affiliation:
Hospital Zonal General de Agudos Dr Ricardo Gutiérrez, La Plata, Argentina
Alberto Claudio Bianchi
Affiliation:
Hospital Zonal General de Agudos Dr Ricardo Gutiérrez, La Plata, Argentina
Gustavo Alvarez
Affiliation:
Instituto Central de Medicina, La Plata, Argentina
Ricardo Pérez
Affiliation:
Instituto Central de Medicina, La Plata, Argentina
Carolina Oyola
Affiliation:
Sanatorio Pasteur, Catamarca, Argentina
*
Address correspondence to Victor Daniel Rosenthal, 11 de Septiembre 4567, Floor 12, Apt 1201, Buenos Aires, 1429, Argentina, www.inicc.org (victor_rosenthal@inicc.org).
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Abstract

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.

DESIGN

This 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.

RESULTS

During 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).

CONCLUSIONS

Implementing 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

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 4 , April 2018 , pp. 445 - 451
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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