DESIGN: A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. SETTING: Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PATIENTS: PICU inpatients. METHODS: We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. RESULTS: During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. CONCLUSIONS: Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
DESIGN: A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. SETTING: Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PATIENTS: PICU inpatients. METHODS: We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. RESULTS: During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. CONCLUSIONS: Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
Authors: V D Rosenthal; S K Todi; C Álvarez-Moreno; M Pawar; A Karlekar; A A Zeggwagh; Z Mitrev; F E Udwadia; J A Navoa-Ng; M Chakravarthy; R Salomao; S Sahu; A Dilek; S S Kanj; H Guanche-Garcell; L E Cuéllar; G Ersoz; A Nevzat-Yalcin; N Jaggi; E A Medeiros; G Ye; Ö A Akan; T Mapp; A Castañeda-Sabogal; L Matta-Cortés; F Sirmatel; N Olarte; H Torres-Hernández; N Barahona-Guzmán; R Fernández-Hidalgo; W Villamil-Gómez; D Sztokhamer; S Forciniti; R Berba; H Turgut; C Bin; Y Yang; I Pérez-Serrato; C E Lastra; S Singh; D Ozdemir; S Ulusoy Journal: Infection Date: 2012-06-19 Impact factor: 3.553
Authors: Anita I Sen; Krystal Balzer; Diane Mangino; Maria Messina; Barbara Ross; Philip Zachariah; Lisa Saiman Journal: Am J Infect Control Date: 2016-02-05 Impact factor: 2.918
Authors: Brett G Mitchell; Oyebola Fasugba; Anne Gardner; Jane Koerner; Peter Collignon; Allen C Cheng; Nicholas Graves; Peter Morey; Victoria Gregory Journal: BMJ Open Date: 2017-11-28 Impact factor: 2.692