International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

doi:10.1016/j.ajic.2014.05.029

American Journal of Infection Control

Volume 42, Issue 9, September 2014, Pages 942-956

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https://doi.org/10.1016/j.ajic.2014.05.029 Get rights and content

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.

Section snippets

Study setting and design

From January 2007-December 2012, we conducted a cohort prospective multicenter surveillance study of device-associated health care–acquired infections (DA-HAIs) in 503 intensive care units (ICUs) in 43 countries from Latin America, Asia, Africa, and Europe currently participating in the INICC. The mean length of participation of hospitals in the INICC program ± SD is 19.5 ± 17.7 months (range, 1-72 months).

The identity of all INICC patients, hospitals, cities, and countries is confidential, in

Results

Characteristics of 503 ICUs that contributed data for this report are shown in Table 1. For the outcome surveillance component, DA-HAI rates, device utilization (DU) ratios, crude excess mortality by specific type of DA-HAI, and bacterial resistance for January 2007-December 2012 are summarized in Table 2, Table 3, Table 4, Table 5, Table 6, Table 7, Table 8, Table 9, Table 10, Table 11, Table 12, Table 13, Table 14, Table 15. Table 2, Table 3, Table 4, Table 5, Table 6, Table 7 show DA-HAI

Discussion

The effectiveness of implementing an integrated infection control program focused on HAI surveillance was demonstrated around 30 years ago as shown in the many studies conducted in the U.S., whose results reported not only that the incidence of HAI can be reduced by as much as 30% but that a related reduction in health care costs was also feasible.³⁵ For >30 years, the CDC's National Nosocomial Infections Surveillance System and NHSN network has provided benchmarking U.S. ICU data on DA-HAIs

Acknowledgments

We thank the many health care professionals at each member hospital who assisted with the conduct of surveillance in their hospital, including the surveillance nurses, clinical microbiology laboratory personnel, and physicians and nurses providing care for the patients during the study; without their cooperation and generous assistance, this International Nosocomial Infection Control Consortium (INICC) would not be possible. We thank Mariano Vilar and Débora López Burgardt, who work at INICC

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: For a list of all the members of the International Nosocomial Infection Control Consortium and all the coauthors of this study, see the Appendix.

: Conflict of interest: None to report.

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Major articleInternational Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Section snippets

Study setting and design

Results

Discussion

Acknowledgments

Am J Infect Control

Am J Infect Control

Am J Infect Control

Am J Infect Control

Am J Infect Control

J Hosp Infect

J Hosp Infect

Int J Infect Dis

Am J Infect Control

Int J Infect Dis

J Crit Care

Am J Infect Control

Am J Infect Control

Am J Infect Control

Am J Infect Control

Am J Infect Control

Lancet

Lancet

Am J Infect Control

Int J Infect Dis

J Crit Care

J Infect Public Health

Am J Infect Control

Int J Infect Dis

J Infect Public Health

Device-associated nosocomial infections in 55 intensive care units of 8 developing countries

Ann Intern Med

Surgical site infections, International Nosocomial Infection Control Consortium (INICC) report, data summary of 30 countries, 2005-2010

Infect Control Hosp Epidemiol

Device-associated infection rates in intensive care units of Brazilian hospitals: findings of the International Nosocomial Infection Control Consortium

Rev Panam Salud Publica

Major article
International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module