OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in three intensive care units (ICUs) from two hospitals in Kuwait City from January 2014 to March 2015. DESIGN: A prospective, before-after study on 2507 adult ICU patients. During baseline, we performed outcome surveillance of VAP applying CDC/NHSN definitions. During intervention, we implemented the IMA through the INICC Surveillance Online System (ISOS), which included: (1) a bundle of infection prevention interventions; (2) education; (3) outcome surveillance; and (4) feedback on VAP rates and consequences. Logistic regression analysis was performed to estimate the effect of the intervention on VAP, controlling for potential bias. RESULTS: During baseline, 1990 mechanical ventilator (MV)-days and 14 VAPs were recorded, accounting for 7.0 VAPs per 1000 MV-days. During intervention, 9786 MV-days and 35 VAPs were recorded, accounting for 3.0 VAPs per 1000 MV-days. The VAP rate was reduced by 57.1% (incidence-density ratio = 0.51; 95% CI = 0.28-0.93; p = 0.042). Logistic regression showed a significant reduction in VAP rate during the intervention phase (OR = 0.39, 95% CI = 0.18-0.83), with 61% effectiveness. CONCLUSIONS: Implementing IMA through ISOS was associated with a significant reduction in the VAP rate in Kuwait ICUs.
OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in three intensive care units (ICUs) from two hospitals in Kuwait City from January 2014 to March 2015. DESIGN: A prospective, before-after study on 2507 adult ICU patients. During baseline, we performed outcome surveillance of VAP applying CDC/NHSN definitions. During intervention, we implemented the IMA through the INICC Surveillance Online System (ISOS), which included: (1) a bundle of infection prevention interventions; (2) education; (3) outcome surveillance; and (4) feedback on VAP rates and consequences. Logistic regression analysis was performed to estimate the effect of the intervention on VAP, controlling for potential bias. RESULTS: During baseline, 1990 mechanical ventilator (MV)-days and 14 VAPs were recorded, accounting for 7.0 VAPs per 1000 MV-days. During intervention, 9786 MV-days and 35 VAPs were recorded, accounting for 3.0 VAPs per 1000 MV-days. The VAP rate was reduced by 57.1% (incidence-density ratio = 0.51; 95% CI = 0.28-0.93; p = 0.042). Logistic regression showed a significant reduction in VAP rate during the intervention phase (OR = 0.39, 95% CI = 0.18-0.83), with 61% effectiveness. CONCLUSIONS: Implementing IMA through ISOS was associated with a significant reduction in the VAP rate in Kuwait ICUs.
Authors: Victor D Rosenthal; Dennis G Maki; Reinaldo Salomao; Carlos Alvarez Moreno; Yatin Mehta; Francisco Higuera; Luis E Cuellar; Ozay Akan Arikan; Rédouane Abouqal; Hakan Leblebicioglu Journal: Ann Intern Med Date: 2006-10-17 Impact factor: 25.391
Authors: Victor D Rosenthal; Carlos Álvarez-Moreno; Wilmer Villamil-Gómez; Sanjeev Singh; Bala Ramachandran; Josephine A Navoa-Ng; Lourdes Dueñas; Ata N Yalcin; Gulden Ersoz; Antonio Menco; Patrick Arrieta; Ana C Bran-de Casares; Lilian de Jesus Machuca; Kavitha Radhakrishnan; Victoria D Villanueva; Maria C V Tolentino; Ozge Turhan; Sevim Keskin; Eylul Gumus; Oguz Dursun; Ali Kaya; Necdet Kuyucu Journal: Am J Infect Control Date: 2011-11-03 Impact factor: 2.918
Authors: Victor D Rosenthal; Hu Bijie; Dennis G Maki; Yatin Mehta; Anucha Apisarnthanarak; Eduardo A Medeiros; Hakan Leblebicioglu; Dale Fisher; Carlos Álvarez-Moreno; Ilham Abu Khader; Marisela Del Rocío González Martínez; Luis E Cuellar; Josephine Anne Navoa-Ng; Rédouane Abouqal; Humberto Guanche Garcell; Zan Mitrev; María Catalina Pirez García; Asma Hamdi; Lourdes Dueñas; Elsie Cancel; Vaidotas Gurskis; Ossama Rasslan; Altaf Ahmed; Souha S Kanj; Olber Chavarría Ugalde; Trudell Mapp; Lul Raka; Cheong Yuet Meng; Le Thi Anh Thu; Sameeh Ghazal; Achilleas Gikas; Leonardo Pazmiño Narváez; Nepomuceno Mejía; Nassya Hadjieva; May Osman Gamar Elanbya; María Eugenia Guzmán Siritt; Kushlani Jayatilleke Journal: Am J Infect Control Date: 2011-09-10 Impact factor: 2.918
Authors: Y Mehta; N Jaggi; V D Rosenthal; C Rodrigues; S K Todi; N Saini; F E Udwadia; A Karlekar; V Kothari; S N Myatra; M Chakravarthy; S Singh; A Dwivedy; N Sen; S Sahu Journal: Epidemiol Infect Date: 2013-03-12 Impact factor: 4.434