Impact of the International Nosocomial Infection Control Consortium's multidimensional approach on rates of ventilator-associated pneumonia in 14 intensive care units in 11 hospitals of 5 cities within Argentina

Rosenthal, Víctor D.; Desse, Javier; Maurizi, Diego; Chaparro, Gustavo Jorge; Orellano, Pablo Wenceslao; Chediack, Viviana; Cabrera, Rafael; Golschmid, Daniel; Silva, Cristina Graciela; Vimercati, Julio César; Stagnaro, Juan Pablo; Perez, Ivanna; Spadaro, María Laura; Montanini, Adriana Miriam; Pedersen, Dina; Paniccia, Teresa Laura; Aguilera, A.; Cermesoni, Raúl; Mele, Juan Ignacio; Alda, Ernesto; Paldoro, Analía Edith; Ortta, Agustín Román; Cooke, Bettina; García, María Cecilia; Obed, Mora; Domínguez, Cecilia Verónica; Saúl, Pablo; Valle, María Cecilia Rodríguez del; Bianchi, Alberto Claudio; Alvarez, Gustavo; Pérez, Ricardo; Oyola, Carolina

doi:10.1016/j.ajic.2017.11.021

Cited by 19 publications

(13 citation statements)

References 31 publications

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“…The first studies were based on adherence to the recommendations of the bundle proposed by the Agency for Healthcare Research and Quality (9). More recently, multidisciplinary working groups were established, which applied evidence-based methodology to select those (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)51,52). In Spain, a task force composed of expert intensivists of different working groups of SEMICYUC, as well as representatives of the SEEIUC, was in charge of selecting preventive measures for the VAP bundle (52).…”

Section: Selection Of Recommendations For the Bundlementioning

confidence: 99%

“The multimodal approach for ventilator-associated pneumonia prevention”—requirements for nationwide implementation

Álvarez-Lerma

García

2018

Ann. Transl. Med

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The multimodal approach for ventilator-associated pneumonia (VAP) prevention has been shown to be a successful strategy in reducing VAP rates in many intensive care units (ICU) in some countries.The simultaneous application of several measures or "bundles" to reduce VAP rates has achieved a higher impact than the progressive implementation of the individual interventions. The ultimate objective of recommendation bundles is their integration in the culture of routine healthcare of the staff in charge of ventilated patients for accomplished rates to persist over time. The noteworthy elements of this new strategy include the selection of the individual recommendations of the bundle, education of care workers (HCW) in the culture of patient safety, audit of compliance with the recommendations, commitment of the hospital management to support implementation, nomination and empowerment of local leaders of the projects in ICUs, both physicians and nurses, and the continuous collection of VAP episodes. The implementation of this new strategy is not an easy task, as both its inherent strength and important barriers to its application have become evident, which need to be overcome for maximal reduction of VAP rates.

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Section: Selection Of Recommendations For the Bundlementioning

confidence: 99%

“The multimodal approach for ventilator-associated pneumonia prevention”—requirements for nationwide implementation

Álvarez-Lerma

García

2018

Ann. Transl. Med

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“…17,46 The impact of the adoption of such resources is to be published in prospective, interventional studies at hospitals that have participated in the INICC over a considerable period. 41,44,45,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]40,62,43 Second, our study was limited by the fact that benchmarking with CDC-NSHN, or other institutions, was not possible because PVCR-BSI rates are not reported to such institutions nor are they determined by PVC days. 63,64 Third, due to the low economic resources of our ICUs, culture orders and processing may have been less than ideal, which likely influenced the rates of PVCR-BSI, and the number of patients for whom blood cultures should have been performed but were not is unknown because these data were not registered.…”

Section: Discussionmentioning

confidence: 99%

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings

Rosenthal¹,

Bat-Erdene²,

Gupta

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).Conclusions:PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

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“…and modified as per hospital policy. Across the world, implementation of such "bundles of care" and adherence to these bundles have been proven to significantly reduce nosocomial infections, especially in the developing countries [1,69]. The infection control team should conduct audits and give necessary feedback regarding compliance with hand-washing and other infection control policies.…”

Section: Strategies For the Prevention Of Nosocomial Infectionsmentioning

confidence: 99%

“…Infection control programs form the most crucial step in the prevention of VAP [69]. VAP rates can be reduced by proper decontamination of ventilatory equipment and practice of infection control measures during care of the mechanically ventilated patient.…”

Section: Prevention Of Vapmentioning

confidence: 99%