Impact of an International Nosocomial Infection Control Consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India

Abstract

Implementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up.

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)

“…5 Within the scope of other studies addressing the burden of CLABSIs in India, the CLABSI rate in our 3WSC group was similar to the rate of 7.92 CLABSIs per 1000 CL-days found in a 2007 study. 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.…”

“…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 Australian intensive care units: Time-trends in infection rates, etiology, and antimicrobial resistance using a comprehensive Victorian surveillance program, 2009-2013

“…22,23 In contrast, S aureus, other Staphylococcus spp, and Candida spp have been the most frequently identified pathogens in Chinese ICUs, 24 with Klebsiella spp, Pseudomonas spp, and Candida spp the most frequent pathogens in Indian ICUs. 25 CNS were reported as the most commonly identified cause of CLABSI in a singlecenter Brazilian study. 26 Notably, our data reflect a predominance of infections due to Enterococcus spp, and a lower incidence of gram-negative infections, unlike these international trends.…”

Estratégia multimodal para prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central: uma revisão integrativa

“…Desta forma, os profissionais responsáveis pela manutenção e inserção do cateter participaram de treinamentos sobre essa temática. A condução desses treinamentos foi diferente entre os estudos, alguns realizaram grupos de discussão 12,18 ; workshop com palestras, vídeos dos procedimentos de inserção e cuidados com o CVC e simulação dessas práticas 13,20 ; palestras e distribuição de cartilhas com as recomendações preconizadas [14][15][16][17]19,21 . As medidas implementadas durante o período de intervenção estavam relacionadas à inserção e manutenção do CVC e estão apresentadas a seguir:…”