Impact of the International Nosocomial Infection Control Consortium (INICC)’s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in 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:10.1017/ice.2017.298

Cited by 13 publications

(12 citation statements)

References 33 publications

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“…Studies from developing countries [ 36 , 37 , 43 , 44 ] that implemented the INICC multidimensional approach showed a statistically significant reduction in the CLABSI rates. Educational interventions that were undertaken in developing countries found substantial benefits similar to the studies that were undertaken in developed countries.…”

Section: Reviewmentioning

confidence: 99%

“…Ten studies were conducted in US institutions [5,[19][20][21][22][23][24][25][26][27]; the remaining were conducted in Brazil (n=3) [28][29][30], Korea (n=1) [31], Saudi Arabia (n=2) [32,33], Germany (n=1) [34], India (n=2) [35,36], Turkey (n=1) [37], Canada (n=3) [38][39][40], Spain (n=1) [41], Bahrain (n=1) [42], and Argentina (n=1) [43]. One study was conducted in 15 countries by the INICC [44].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…One study was conducted in trauma ICU [32]. The remaining studies were undertaken in general ICUs (n=15) [5,[19][20][21]24,27,33,34,[36][37][38][41][42][43][44]. Three of them focused only on the physicians as the target population for the intervention [5,22,40], while the remaining 24 studies focused on both physicians' and nurses' groups (Table 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Prevention of Central Line-Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review

Foka¹,

Nicolaou²,

Kyprianou³

et al. 2021

Cureus

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Central line-associated bloodstream infections (CLABSIs) represent a severe systemic threat to patients admitted in ICUs and contribute to increased mortality, prolonged length of stay in ICUs, and increased costs. The majority of CLABSIs are preventable. The current systematic review aimed to investigate the effectiveness of educational methods on CLABSI rates in adult ICUs. A systematic literature search was conducted using the electronic databases of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Cochrane Database of Systematic Reviews for studies published from the beginning of 1995 to March 2020. The terms used for the search were as follows: central venous catheters, infection, central line-associated bloodstream infections, intensive care unit, and education intervention in all possible combinations and using the word ‘and’ between them. Data were extracted independently and crosschecked by two authors using a standard data collection form. The quality of the studies included in the review was assessed using the Methodological Index for Non-randomized Studies (MINORS). The current systematic review included 27 interventional studies of central line insertion or maintenance or both in adult ICU settings with documentation of the CLABSI incidence expressed per 1,000 catheter days. A large deviation between the length of time and type of educational interventions was found. Statistical significance was found in all studies (except one) in terms of CLABSI reduction despite the large variation of the length or the type of the educational intervention. Continuing education on infection prevention may be necessary to maintain the post-intervention results and improve clinical outcomes.

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Section: Reviewmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Prevention of Central Line-Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review

Foka¹,

Nicolaou²,

Kyprianou³

et al. 2021

Cureus

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“…Increasing hand hygiene compliance and improving compliance with infection control bundles have proven to be successful strategies to prevent CLABSIs as described in several INICC publications. 28,[30][31][32][33][34][35][36][37][38][39] The present data can guide the implementation of prevention strategies and other quality improvement efforts for the reduction of PIVCR BSI rates and their adverse consequences. This study has several limitations.…”

Section: Discussionmentioning

confidence: 82%

An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)

Rosenthal¹,

Chaparro

Servolo-Medeiros

et al. 2021

Infect. Control Hosp. Epidemiol.

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Background: Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied. Methods: International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used. Results: In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040). The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%. Conclusions: Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.

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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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Impact of the International Nosocomial Infection Control Consortium (INICC)’s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina

Cited by 13 publications

References 33 publications

Prevention of Central Line-Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review

Prevention of Central Line-Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review

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