Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC)

Abstract

This study shows that the implementation of a multidimensional infection control strategy was associated with a significant reduction in the CLAB rates in the PICUs of developing countries.

Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line–associated bloodstream infection rates in India: a randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)

“…3 In previous studies performed by INICC member hospitals, it was shown that the implementation of a 6-component multidimensional approach for CLABSI resulted in significant reductions in CLABSI rates in Argentina (45.9 vs 11.1 CLABSIs per 1000 CL-days), 13 in Mexico (46.3 vs 19.5 CLABSIs per 1000 CL-days), 12 in Turkey (22.7 vs 12.0 CLABSIs per 1000 CL-days), 9 in India (6.4 vs 3.9 CLABSIs per 1000 CL-days), 8 11 However, in none of the previous studies conducted by INICC the CLABSI rate was lower than 5.2 CLABSIs per 1000 CL-days, as was achieved in the SS þ SUF group. [8][9][10][11][12][13][14] This finding is consistent with the fact that according to the INICC, between 88% and 94% of hospitals in the developing world use 3WSC devices instead of SS þ SUF devices. 14 In the present study, our comparison showed that using SS þ SUF devices would save $402.88 per patient.…”

“…6,7 However, to date only 2 studies addressing this issue have been published, which showed higher CLABSI rates in pediatric ICUs in lower-middle-income countries compared with upper-middle-income countries, 6 and significantly higher CLABSI rates in neonatal ICU patients from low-income countries than in lower-middle or upper-middle-income countries. 7 In the developing countries, including India, 8 it has been demonstrated that CLABSI rates can be reduced by more than 50% [8][9][10][11][12][13][14] by adopting a multidimensional approach with the simultaneous implementation of 6 elements: (1) a bundle of interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback.…”

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

“…23 This emphasizes the importance of promptly removing unnecessary CVCs, particularly during the second week of catheterization and thereafter. 13,20,23 Niedner et al 13 reported that CLABSI incidence was 3.1/1000 central line-days in the PICUs in the USA between October 2006 and December 2007. They found that 99% of patients with CLABSI were infection-free through day 7, but they demonstrated the daily risk of CLABSI doubled to 0.27% per day.…”

What is the right approach to infection prevention and control for children living at home with invasive devices?

“…(32) The implementation of care bundles -which group together evidence-based interventions that have to be consistently performed for every patient, every time -has produced impressive results in adult intensive care units as well as for a variety of HCAIs in the hospital setting, for instance. (33,34) Importantly, the research evidence suggests that the success of the bundle approach is likely to rely as much on understanding the human and structural factors in which these interventions take place as on the evidence base for the technical components. (35,36) Much of the success to date has been reported in adult populations.…”