BACKGROUND: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in 11 hospitals within 5 cities of Argentina from January 2014-April 2017. METHODS: A multicenter, prospective, before-after surveillance study was conducted through the use of International Nosocomial Infection Control Consortium Surveillance Online System. During baseline, we performed outcome surveillance of VAP applying the definitions of the Centers for Disease Control andPrevention's National Healthcare Safety Network. During intervention, we implemented the IMA, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on VAP rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention. RESULTS: We recorded 3,940 patients admitted to 14 intensive care units. At baseline, there were 19.9 VAPs per 1,000 mechanical ventilator (MV)-days-with 2,920 MV-days and 58 VAPs, which was reduced during intervention to 9.4 VAPs per 1,000 MV-days-with 9,261 MV-days and 103 VAPs. This accounted for a 52% rate reduction (incidence density rate, 0.48; 95% confidence interval, 0.3-0.7; P .001). CONCLUSIONS: Implementing the IMA was associated with significant reductions in VAP rates in intensive care units within Argentina.
BACKGROUND: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in 11 hospitals within 5 cities of Argentina from January 2014-April 2017. METHODS: A multicenter, prospective, before-after surveillance study was conducted through the use of International Nosocomial Infection Control Consortium Surveillance Online System. During baseline, we performed outcome surveillance of VAP applying the definitions of the Centers for Disease Control andPrevention's National Healthcare Safety Network. During intervention, we implemented the IMA, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on VAP rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention. RESULTS: We recorded 3,940 patients admitted to 14 intensive care units. At baseline, there were 19.9 VAPs per 1,000 mechanical ventilator (MV)-days-with 2,920 MV-days and 58 VAPs, which was reduced during intervention to 9.4 VAPs per 1,000 MV-days-with 9,261 MV-days and 103 VAPs. This accounted for a 52% rate reduction (incidence density rate, 0.48; 95% confidence interval, 0.3-0.7; P .001). CONCLUSIONS: Implementing the IMA was associated with significant reductions in VAP rates in intensive care units within Argentina.
Authors: Victor Daniel Rosenthal; Ruijie Yin; Sandra Liliana Valderrama-Beltran; Sandra Milena Gualtero; Claudia Yaneth Linares; Guadalupe Aguirre-Avalos; Julio Cesar Mijangos-Méndez; Miguel Ángel Ibarra-Estrada; Luisa Fernanda Jimenez-Alvarez; Lidia Patricia Reyes; Carlos Arturo Alvarez-Moreno; Maria Adelia Zuniga-Chavarria; Ana Marcela Quesada-Mora; Katherine Gomez; Johana Alarcon; Jose Millan Oñate; Daisy Aguilar-De-Moros; Elizabeth Castaño-Guerra; Judith Córdoba; Alejandro Sassoe-Gonzalez; Claudia Marisol Millán-Castillo; Lissette Leyva Xotlanihua; Lina Alejandra Aguilar-Moreno; Juan Sebastian Bravo Ojeda; Ivan Felipe Gutierrez Tobar; Mary Cruz Aleman-Bocanegra; Clara Veronica Echazarreta-Martínez; Belinda Mireya Flores-Sánchez; Yuliana Andrea Cano-Medina; Edwin Giovannny Chapeta-Parada; Rafael Antonio Gonzalez-Niño; Maria Isabel Villegas-Mota; Mildred Montoya-Malváez; Miguel Ángel Cortés-Vázquez; Eduardo Alexandrino Medeiros; Dayana Fram; Daniela Vieira-Escudero; Zhilin Jin Journal: J Epidemiol Glob Health Date: 2022-10-05