International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009


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Rosenthal V. D. , Hu Bijie H. B. , Maki D. G. , Mehta Y., Apisarnthanarak A., Medeiros E. A. , ...More

AMERICAN JOURNAL OF INFECTION CONTROL, vol.40, no.5, pp.396-407, 2012 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 5
  • Publication Date: 2012
  • Doi Number: 10.1016/j.ajic.2011.05.020
  • Journal Name: AMERICAN JOURNAL OF INFECTION CONTROL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.396-407
  • Keywords: Network, Hospital infection, Nosocomial infection, Health care-associated infection, Device-associated infection, Ventilator-associated pneumonia, Catheter-associated urinary tract infection, Central line-associated bloodstream infection, Bloodstream infection, Urinary tract infection, Antibiotic resistance, Developing countries, Limited-resources countries, Low-income countries, INTENSIVE-CARE UNITS, LENGTH-OF-STAY, VENTILATOR-ASSOCIATED PNEUMONIA, BLOOD-STREAM INFECTIONS, PERFORMANCE FEEDBACK, ARGENTINEAN HOSPITALS, CONTROL PROGRAM, SAFETY NETWORK, RATES, MORTALITY
  • Karadeniz Technical University Affiliated: No

Abstract

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright (C) 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.