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Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004–2013: Findings of the International Nosocomial Infection Control Consortium

  • Yatin Mehta (a1), Namita Jaggi (a2), Victor Daniel Rosenthal (a3), Maithili Kavathekar (a4), Asmita Sakle (a5), Nita Munshi (a6), Murali Chakravarthy (a7), Subhash Kumar Todi (a8), Narinder Saini (a9), Camilla Rodrigues (a10), Karthikeya Varma (a11), Rekha Dubey (a12), Mohammad Mukhit Kazi (a13), F. E. Udwadia (a14), Sheila Nainan Myatra (a15), Sweta Shah (a16), Arpita Dwivedy (a17), Anil Karlekar (a18), Sanjeev Singh (a19), Nagamani Sen (a20), Kashmira Limaye-Joshi (a21), Bala Ramachandran (a22), Suneeta Sahu (a23), Nirav Pandya (a24), Purva Mathur (a25), Samir Sahu (a26), Suman P. Singh (a27), Anil Kumar Bilolikar (a28), Siva Kumar (a29), Preeti Mehta (a30), Vikram Padbidri (a31), N. Gita (a32), Saroj K. Patnaik (a33), Thara Francis (a34), Anup R. Warrier (a35), S. Muralidharan (a36), Pravin Kumar Nair (a37), Vaibhavi R. Subhedar (a38), Ramachadran Gopinath (a39), Afzal Azim (a40) and Sanjeev Sood (a41)...

Abstract

OBJECTIVE

To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.

METHODS

Surveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.

RESULTS

We collected data from 236,700 ICU patients for 970,713 bed-days

Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days

In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days

Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP

Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs

Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.

CONCLUSIONS

Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.

Infect. Control Hosp. Epidemiol. 2016;37(2):172–181

Copyright

Corresponding author

Address correspondence to Victor Daniel Rosenthal, MD, 11 de Septiembre 4567, Floor 12th, Apt 1201, Buenos Aires, ZIP 1429, Argentina (victor_rosenthal@inicc.org).

Footnotes

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Additional authors are listed at the end of the text.

Footnotes

References

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3. Jaggi, N, Sissodia, P. Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India. J Clin Diagn Res 2012;6:13721376.
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8. Gautham, M, Shyamprasad, KM, Singh, R, Zachariah, A, Bloom, G. Informal rural healthcare providers in North and South India. Health Policy Plan 2014;29:i20i29.
9. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting, 2013. CDC website. http://www.cdc.gov/nhsn/. Accessed August 2015.
10. Rosenthal, VD, Udwadia, FE, Kumar, S, et al. 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). Am J Infect Control 2015;43:10401045.
11. Maki, DG, Rosenthal, VD, Salomao, R, Franzetti, F, Rangel-Frausto, MS. Impact of switching from an open to a closed infusion system on rates of central line-associated bloodstream infection: a meta-analysis of time-sequence cohort studies in 4 countries. Infect Control Hosp Epidemiol 2011;32:5058.
12. Rosenthal, VD, Maki, DG, Salomao, R, et al. Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 2006;145:582591.
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15. Rosenthal, VD, Alvarez-Moreno, C, Villamil-Gomez, W, et al. Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings. Am J Infect Control 2012;40:497501.
16. Rosenthal, VD, Rodriguez-Calderon, ME, Rodriguez-Ferrer, M, et al. Findings of the International Nosocomial Infection Control Consortium (INICC), part II: impact of a multidimensional strategy to reduce ventilator-associated pneumonia in neonatal intensive care units in 10 developing countries. Infect Control Hosp Epidemiol 2012;33:704710.
17. Rosenthal, VD, Rodrigues, C, Alvarez-Moreno, C, et al. Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14 developing countries of four continents: findings of the International Nosocomial Infection Control Consortium. Crit Care Med 2012;40:31213128.
18. Rosenthal, VD, Jarvis, WR, Jamulitrat, S, et al. Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: International Nosocomial Infection Control Consortium findings. Pediatr Crit Care Med 2012;13:399406.
19. Rosenthal, VD, Lynch, P, Jarvis, WR, et al. Socioeconomic impact on device-associated infections in limited-resource neonatal intensive care units: findings of the INICC. Infection 2011;39:439450.

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