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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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