Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/56551
Title: Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe
Authors: Rosenthal, V.D.
Jin, Z.
Yin, R.
Sahu, S.
Rajhans, P.
Kharbanda, M.
Nair, P.K.
Mishra, Shakti Bedanta
Chawla, Rajesh
Arjun, Rajalakshmi
Sandhu, Kavita
Rodrigues, Camilla
Dongol, Reshma
Myatra, Sheila Nainan
Mohd-Basri, Mat Nor
Chian-Wern, Tai
Bhakta, Arpita
Bat-Erdene, Ider
Acharya, Subhash P.
Alvarez, Gustavo Andres
Moreno, Lina Alejandra Aguilar
Gomez, Katherine
da Jimenez-Alvarez, Luisa Fernanda
Henao-Rodas, Claudia Milena
Valderrama-Beltran, Sandra Liliana
Zuniga-Chavarria, Maria Adelia
Aguirre-Avalos, Guadalupe
Hernandez-Chena, Blanca Estela
Sassoe-Gonzalez, Alejandro
Aleman-Bocanegra, Mary Cruz
Villegas-Mota, Maria Isabel
De Moros, Daisy Aguilar
Castaneda-Sabogal, Alex
Carreazo, Nilton Yhuri
Alkhawaja, Safaa
Agha, Hala Mounir
El-Kholy, Amani
Abdellatif-Daboor, Mohammad
Dursun, Oguz
Okulu, Emel
Havan, Merve
Yildizdas, Dincer
Deniz, Suna Secil Ozturk
Guclu, Ertugrul
Hlinkova, Sona
Ikram, Aamer
Tao, Lili
Omar, Abeer Aly
Elahi, Naheed
Memish, Ziad A.
Petrov, Michael M.
Raka, Lul
Janc, Jarosław
Horhat-Florin, George
Medeiros, Eduardo Alexandrino
Salgado, Estuardo
Dueñas, Lourdes
Coloma, Monica
Perez, Valentina
Brown, Eric Christopher
Keywords: Developing countries
Device-associated infection
Healthcare-associated infection
Hospital infection
Limited resources countries
Low-income countries
Network
Nosocomial infection
Ventilator-associated pneumonia
Publisher: W.B. Saunders
Abstract: Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P < 0.001); 11.40 at the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P < 0.001), and to 9.68 at the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. Conclusions: This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period. © 2023
URI: https://doi.org/10.1016/j.jcrc.2023.154500
https://hdl.handle.net/11499/56551
ISSN: 0883-9441
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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