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Multicenter Study
. 2018 Sep-Oct;11(5):677-684.
doi: 10.1016/j.jiph.2018.06.002. Epub 2018 Jun 23.

Impact of the International Nosocomial Infection Control Consortium (INICC)'s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

Hail M Al-Abdely  1 , Yassir Khidir Mohammed  1 , Victor D Rosenthal  2 , Pablo W Orellano  3 , Mohamed ALazhary  4 , Eman Kaid  5 , Anan Al-Attas  5 , Ghadeer Hawsawi  5 , Ashraf Kelany  6 , Bedoor Hussein  5 , Bayan Esam  5 , Rami Altowerqi  7 , Modhi A Alkamaly  8 , Nader A Tawfic  9 , Elinita Cruzpero  9 , Raya M Al Rashidi  9 , Reny Thomas  9 , Apsia M Molano  10 , Hessa A Al Enazy  10 , Fatima M Al Adwani  10 , Arlu M Casuyon Pahilanga  10 , Sharifa Alatawi  10 , Raslan Nakhla  10 , Fatma M Al Adwani  10 , Rosita Gasmin Aromin  11 , Evangelina Balon Ubalde  11 , Hanan Hanafy Diab  12 , Nahla A Kader  11 , Ibtesam Y Hassan Assiry  11 , Fahad A Sawan  13 , Hassan E Ammari  13 , Alhasan M Mashiakhy  13 , Elaine B Santiago  13 , Christian M S Chua  13 , Imee M Dalis  13 , Haider M Arishi  13 , Ruthelma Lozada  13 , Ibrahim A M Al-Zaydani Asiri  14 , Hala Ahmed  14 , Al Jarie  14 , Ali S M Al-Qathani  14 , Halima Y Al-Alkami  14 , Mervat AlDalaton  15 , Siti J B Alih  14 , Mohammed J Alaliany  15 , Najla J Helali  16 , Grace Sindayen  16 , Annalyn A Malificio  16 , Haya B Al Dossari  16 , Abdulmajid G Algethami  17 , Dia Mohamed  16 , Leigh Yanne  16 , Avigail Tan  16 , Sheema Babu  16 , Shatha M Abduljabbar  16 , Hala Rushdi  18 , Janice Fernandez  19 , Waleed M Hussain  19 , Renuga D Rajavel  19 , Syed Z Bukhari  19 , Abdullah A Turkistani  20 , Jeyashri J Mushtaq  20 , Eida Albeladi  21 , Sally Aboushoushah  21 , Nahed Qushmaq  21 , Leide Shyrine  22 , Jomol Philipose  22 , Mohamed Raees  22 , Nawal S AbdulKhalik  22 , Marjory Madco  23 , Mohd Abdulghany  23 , Athena Manao  23 , Catherine Acostan  23 , Rania Safwat  23 , Muhammad Halwani  23 , Nahla A H Abdul Aal  23 , Anumol Thomas  23 , Shaymaa M Abdulatif  23 , Nelia C Ariola  24 , Aisha H Mutwalli  24 , Nelia Ariola  24 , Eatedal Bohlega  25 , Saly Simon  25 , Estelita Damlig  25 , Sherin G Elsherbini  25 , Ilama T Krishne  25 , Sheela Abraham  25 , Mohammed A Ali Karrar  26 , Nisreen A Gosn  26 , Abdulaziz A Al Hindi  27 , Rasha N Jaha  26 , Saeda M AlQahtani  28 , Ali O Abdul Aziz  29 , Nadia L Demaisip  29 , Elizabeth Laungayan Cortez  29 , Analen F Cabato  29 , Jerlie M Gonzales Celiz  29 , Mohammed A Al Raey  29 , Saeed A Al Darani  29 , Misbah R Aziz  29 , Batool A Manea  29 , Eslam Samy  29 , Solita Briones  30 , Radhika Krishnan  30 , Saman S M Raees  30 , Kehkashan Tabassum  30 , Khalid M Ghalilah  31 , Mohamed Alradady  31 , Abdulrahim Al Qatri  31 , Mafaten Chaouali  31 , Magdy Elsisi  31 , Hajer A Aldossary  32 , Shehab Al-Suliman  32 , Amina A Al Talib  33 , Nadira Albaghly  32 , Mohammad E Haqlre Mia  32 , Manal M Al-Gethamy  34 , Dhafer M Alamri  34 , Adnan S Al-Saadi  34 , Evelyn P Ayugat  35 , Nawaf A Al Hazazi  35 , Modi I Al Hussain  35 , Yvonne Caminade  36 , Ann J Santos  36 , Mohamed H Abdulwahab  36 , Bushra T A Al-Garni  36
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Free article
Multicenter Study

Impact of the International Nosocomial Infection Control Consortium (INICC)'s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

Hail M Al-Abdely et al. J Infect Public Health. 2018 Sep-Oct.
Free article

Abstract

Background: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017.

Methods: A multicenter, prospective, before-after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention.

Results: The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days-with 20,927 MV-days and 164 VAPs-, was reduced to 4.74 VAPs per 1000 MV-days-with 118,929 MV-days and 771 VAPs-, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5-0.7; P 0.001).

Conclusions: Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia.

Keywords: Healthcare-acquired infection; Hospital infection; Hospital-acquired pneumonia; Limited-resource countries; Nosocomial pneumonia; Surveillance.

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