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. 2016 Dec 1;44(12):1495-1504.
doi: 10.1016/j.ajic.2016.08.007. Epub 2016 Oct 11.

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

Víctor Daniel Rosenthal  1 , Hail M Al-Abdely  2 , Amani Ali El-Kholy  3 , Safa A Aziz AlKhawaja  4 , Hakan Leblebicioglu  5 , Yatin Mehta  6 , Vineya Rai  7 , Nguyen Viet Hung  8 , Souha Sami Kanj  9 , Mona Foda Salama  10 , Estuardo Salgado-Yepez  11 , Naheed Elahi  12 , Rayo Morfin Otero  13 , Anucha Apisarnthanarak  14 , Braulio Matias De Carvalho  15 , Bat Erdene Ider  16 , Dale Fisher  17 , Maria Carmen S G Buenaflor  18 , Michael M Petrov  19 , Ana Marcela Quesada-Mora  20 , Farid Zand  21 , Vaidotas Gurskis  22 , Tanja Anguseva  23 , Aamer Ikram  24 , Daisy Aguilar de Moros  25 , Wieslawa Duszynska  26 , Nepomuceno Mejia  27 , Florin George Horhat  28 , Vladislav Belskiy  29 , Vesna Mioljevic  30 , Gabriela Di Silvestre  31 , Katarina Furova  32 , Gloria Y Ramos-Ortiz  33 , May Osman Gamar Elanbya  34 , Hindra Irawan Satari  35 , Umesh Gupta  36 , Tarek Dendane  37 , Lul Raka  38 , Humberto Guanche-Garcell  39 , Bijie Hu  40 , Denis Padgett  41 , Kushlani Jayatilleke  42 , Najla Ben Jaballah  43 , Eleni Apostolopoulou  44 , Walter Enrique Prudencio Leon  45 , Alejandra Sepulveda-Chavez  46 , Hector Miguel Telechea  47 , Andrew Trotter  48 , Carlos Alvarez-Moreno  49 , Luis Kushner-Davalos  50 ; Remaining authors
Collaborators, Affiliations

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

Víctor Daniel Rosenthal et al. Am J Infect Control. .

Abstract

Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.

Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days.

Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs.

Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically.

Keywords: Antibiotic resistance; Bloodstream infection; Catheter-associated urinary tract infection; Central line-associated bloodstream infections; Developing countries; Health care-associated infection; Hospital infection; Limited resources countries; Urinary tract infection; Ventilator-associated pneumonia.

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