Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive careunits of 15 developing countries
AuthorsPontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Grupo de Investigación en Enfermedades Infecciosas HUSI - PUJ
Rosenthal, Víctor Daniel
Maki, Dennis George
Álvarez-Moreno, Carlos Arturo
Medeiros, Eduardo A.
Cuéllar, Luis E.
Kanj, Souha S.
International Nosocomial Infection Control Consortium Investigators
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0899-823X / 1559-6834 (Electrónico)
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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.
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Link to the resourcehttps://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/impact-of-international-nosocomial-infection-control-consortium-inicc-strategy-on-central-lineassociated-bloodstream-infection-rates-in-the-intensive-care-units-of-15-developing-countries/3A6FF1B7BE6FBB7C74FFB8822839E5CD
SourceInfection Control & Hospital Epidemiology; Vol. 31 Núm. 12 (2010)
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