OBJECTIVE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India. METHODS: This was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods. RESULTS: During the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31-0.70; p=0.0001). CONCLUSIONS: Implementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up.
OBJECTIVE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India. METHODS: This was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods. RESULTS: During the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31-0.70; p=0.0001). CONCLUSIONS: Implementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up.
Keywords:
Bundle; Catheter-related infections; Developing countries; Hand hygiene; International Nosocomial Infection Control Consortium; Multidimensional approach
Authors: Hail M Al-Abdely; Areej Dhafer Alshehri; Victor Daniel Rosenthal; Yassir Khidir Mohammed; Weam Banjar; Pablo Wenceslao Orellano; Abdullah Mufareh Assiri; Nahla Moustafa Abedel Kader; Hessa Abdullah Al Enizy; Diaa Abdullah Mohammed; Duaa Khalil Al-Awadi; Analen Fabros Cabato; Maria Wasbourne; Randa Saliya; Rosita Gasmin Aromin; Evangelina Balon Ubalde; Hanan Hanafy Diab; Modhi Abdullah Alkamaly; Nawal Mohammed Alanazi; Ibtesam Yahia Hassan Assiry; Apsia Musa Molano; Celia Flores Baldonado; Mohamed Al-Azhary; Sharifa Al Atawi; Apsia Musa Molano; Fatima Mohammad Al Adwani; Arlu Marie Casuyon Pahilanga; Raslan Nakhla; Fatma Mohammad Al Adwani; Deepa Sasithran Nair; Grace Sindayen; Annalyn Amor Malificio; Najla Jameel Helali; Haya Barjas Al Dossari; Ashraf Kelany; Abdulmajid Ghowaizi Algethami; Leigh Yanne; Avigail Tan; Sheema Babu; Shatha Mohammad Abduljabbar; Syed Zahid Bukhari; Roaa Hasan Basri; Jeyashri Jaji Mushtaq; Hala Rushdi; Abdullah Abdulaziz Turkistani; Jerlie Mae Gonzales Celiz; Mohammed Abdullah Al Raey; Ibrahim Am Al-Zaydani Asiri; Saeed Ali Aldarani; Elizabeth Laungayan Cortez; Nadia Lynette Demaisip; Misbah Rehman Aziz; Ali Omer Abdul Aziz; Batool Al Manea; Eslam Samy; Mervat Al-Dalaton; Mohammed Jkedeb Alaliany Journal: J Infect Prev Date: 2016-10-22
Authors: Estuardo Salgado Yepez; Maria M Bovera; Victor D Rosenthal; Hugo A González Flores; Leonardo Pazmiño; Francisco Valencia; Nelly Alquinga; Vanessa Ramirez; Edgar Jara; Miguel Lascano; Veronica Delgado; Cristian Cevallos; Gasdali Santacruz; Cristian Pelaéz; Celso Zaruma; Diego Barahona Pinto Journal: World J Biol Chem Date: 2017-02-26
Authors: Elizabeth A Ashley; Judith Recht; Arlene Chua; David Dance; Mehul Dhorda; Nigel V Thomas; Nisha Ranganathan; Paul Turner; Philippe J Guerin; Nicholas J White; Nicholas P Day Journal: J Antimicrob Chemother Date: 2018-07-01 Impact factor: 5.790