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Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries

Published online by Cambridge University Press:  02 January 2015

Victor D. Rosenthal ,
Bala Ramachandran ,
Lourdes Dueñas ,
Carlos Álvarez-Moreno ,
J. A. Navoa-Ng ,
Alberto Armas-Ruiz ,
Gulden Ersoz ,
Lorena Matta-Cortés ,
Mandakini Pawar  and
Ata Nevzat-Yalcin
...Show all authors
Victor D. Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Bala Ramachandran
Affiliation:
KK Childs Trust Hospital, Chennai, India
Lourdes Dueñas
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
Carlos Álvarez-Moreno
Affiliation:
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia
J. A. Navoa-Ng
Affiliation:
St. Luke's Medical Center, Quezon City, Philippines
Alberto Armas-Ruiz
Affiliation:
Centro Médico La Raza IMSS, Mexico City, Mexico
Gulden Ersoz
Affiliation:
Mersin University, Faculty of Medicine, Mersin, Turkey
Lorena Matta-Cortés
Affiliation:
Corporación Comfenalco Valle- Universidad Libre, Santiago de Cali, Colombia
Mandakini Pawar
Affiliation:
Pushpanjali Crosslay Hospital, Ghaziabad, India
Ata Nevzat-Yalcin
Affiliation:
Akdeniz University, Antalya, Turkey
Marena Rodriguez-Ferrer
Affiliation:
Universidad Simón Bolivar, Barranquilla, Colombia
Ana Concepción Bran de Casares
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
Claudia Linares
Affiliation:
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia
Victoria D. Villanueva
Affiliation:
St. Luke's Medical Center, Quezon City, Philippines
Roberto Campuzano
Affiliation:
Centro Médico La Raza IMSS, Mexico City, Mexico
Ali Kaya
Affiliation:
Mersin University, Faculty of Medicine, Mersin, Turkey
Luis Fernando Rendon-Campo
Affiliation:
Corporación Comfenalco Valle- Universidad Libre, Santiago de Cali, Colombia
Amit Gupta
Affiliation:
Pushpanjali Crosslay Hospital, Ghaziabad, India
Ozge Turhan
Affiliation:
Akdeniz University, Antalya, Turkey
Nayide Barahona-Guzmán
Affiliation:
Universidad Simón Bolivar, Barranquilla, Colombia
Lilian de Jesús-Machuca
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
María Corazon V. Tolentino
Affiliation:
St. Luke's Medical Center, Quezon City, Philippines
Jorge Mena-Brito
Affiliation:
Centro Médico La Raza IMSS, Mexico City, Mexico
Necdet Kuyucu
Affiliation:
Mersin University, Faculty of Medicine, Mersin, Turkey
Yamileth Astudillo
Affiliation:
Corporación Comfenalco Valle- Universidad Libre, Santiago de Cali, Colombia
Narinder Saini
Affiliation:
Pushpanjali Crosslay Hospital, Ghaziabad, India
Nurgul Gunay
Affiliation:
Akdeniz University, Antalya, Turkey
Guillermo Sarmiento-Villa
Affiliation:
Universidad Simón Bolivar, Barranquilla, Colombia
Eylul Gumus
Affiliation:
Akdeniz University, Antalya, Turkey
Alfredo Lagares-Guzmán
Affiliation:
Universidad Simón Bolivar, Barranquilla, Colombia
Oguz Dursun
Affiliation:
Akdeniz University, Antalya, Turkey
*
Avenue Corrientes 4580, Piso 12, “D”, Buenos Aires (C1195AAR), Argentina (victor_rosenthal@inicc.org)
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Abstract

Design.

A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.

Setting.

Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.

Patients.

PICU inpatients.

Methods.

We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.

Results.

During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21–1.0]), indicating a rate reduction of 57%.

Conclusions.

Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 7 , July 2012 , pp. 696 - 703
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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