Title
Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries
Date Issued
01 January 2010
Access level
open access
Resource Type
journal article
Author(s)
Rosenthal V.D.
Maki D.G.
Rodrigues C.
Álvarez-Moreno C.
Leblebicioglu H.
Sobreyra-Oropeza M.
Berba R.
Madani N.
Medeiros E.A.
Mitrev Z.
Dueñas L.
Guanche-Garcell H.
Mapp T.
Kanj S.S.
Fernández-Hidalgo R.
Viegas M.
Di Núbila B.M.A.
Lanzetta D.
Fernández L.J.
Rossetti M.A.
Romani A.
Migazzi C.
Barolin C.
Martínez E.
Sztokhamer D.
Soroka L.C.
Flynn L.P.
Rausch D.
Spagnolo A.
Forciniti S.
Blasco M.
Lezcano C.B.
Lastra C.E.
Angelieri D.B.
Salomao R.
Da Silva M.A.M.
Vilins M.
Da Silva E.H.
Blecher S.
Grinberg G.
Linares C.
Gómez W.V.
Vergara G.R.
Arrieta P.
Osorio L.
Guzmán N.B.
Ferrer M.R.
Villa G.S.
Guzmán A.L.
Sussmann O.
Mojica B.E.
Olarte N.
Valderrama A.
Dajud L.
Mendoza M.
Bernate P.H.A.
Calderón M.E.R.
Calzada J.M.A.
Muñoz G.
Argüello A.R.
Pérez C.M.
De Casares A.C.B.
De Machuca L.J.
Hegd A.
Kapadia F.
Todi S.K.
Chakraborty P.
Chatterjee S.
Chakravarthy M.
Jawali V.
Adhikary R.
Singh S.
Kumar R.K.
Radhakrishnan K.
Karlekar A.
Kapoor P.
Pawar M.
Udwadia F.E.
Ansari R.
Poojary A.
Koppikar G.
Bhandarkar L.
Sen N.
Subramani K.
Raj J.P.
Myatra S.N.
Divatia J.V.
Kelkar R.
Biswas S.
Singhal H.
Raut S.
Mahale N.
Dhakate V.
Sampat S.
Ramachandran B.
Zahreddine N.
Sidani N.
Jurdi L.A.
Kanafani Z.
Publisher(s)
University of Chicago Press
Abstract
BACKGROUND. The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS. Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS. During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001 ), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P=.018 ), and that sought to remove unneeded catheters increased from 37% to 83% (P=.004); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS. Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years. © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved.
Start page
1264
End page
1272
Volume
31
Issue
12
Language
English
OCDE Knowledge area
Enfermedades infecciosas
Ciencias del cuidado de la salud y servicios (administración de hospitales, financiamiento)
Políticas de salud, Servicios de salud
DOI
Scopus EID
2-s2.0-78649944895
PubMed ID
Source
Infection Control and Hospital Epidemiology
ISSN of the container
0899823X
Sponsor(s)
Rosenthal Victor D. MD, MSc, CIC Maki Dennis G. MD Rodrigues Camila MD Álvarez-Moreno Carlos MD, MSc, DTM&H Leblebicioglu Hakan MD Sobreyra-Oropeza Martha MD, HCA Berba Regina MD Madani Naoufel MD Medeiros Eduardo A. MD, PhD Cuéllar Luis E. MD Mitrev Zan MD, FETCS Dueñas Lourdes MD Guanche-Garcell Humberto MD Mapp Trudell RN Kanj Souha S. MD, FACP, FIDSA Fernández-Hidalgo Rosalía RN, MSc International Nosocomial Infection Control Consortium Investigators Medical College of Buenos Aires , Argentina Mumbai , India University of Wisconsin School of Medicine and Public Health , Madison , Mumbai , India P. D. Hinduja National Hospital and Medical Research Centre , Mumbai , India San Ignacio University Hospital , Pontificia Javeriana University , Bogota , Colombia Ondokuz Mayis University Medical School , Samsun , Turkey De la Mujer Hospital , Mexico City , Mexico Philippine General Hospital , Manila , Philippines Medical Intensive Care Unit , Ibn Sina , Rabat , Morocco Hospital Sao Paulo , Federal University of Sao Paulo , UNIFESP , Brazil Instituto Nacional de Enfermedades Neoplásicas (INEN) , Lima , Peru Filip II Special Cardiosurgery Hospital , Skopje , Macedonia Hospital Nacional de Niños Benjamin Bloom , San Salvador , El Salvador Joaquín Albarrán Dominguez University Hospital , Havana , Cuba San Fernando Hospital , Panama City , Panama American University of Beirut Medical Center , Beirut , Lebanon Clínica Bíblica Hospital , San José , Costa Rica Corrientes Ave 4580 , Floor 12 , Apt D , Zip 1195 , Buenos Aires , Argentina , ( victor_rosenthal@inicc.org ) 12 2010 31 12 1264 1272 27 04 2010 11 06 2010 Copyright © The Society for Healthcare Epidemiology of America 2010 2010 The Society for Healthcare Epidemiology of America
Sources of information:
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Scopus