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https://hdl.handle.net/11499/56880
Title: | Decreasing central line-associated bloodstream infections rates in intensive care units in 30 low- and middle-income countries: An INICC approach | Authors: | Rosenthal, V.D. Jin, Z. Brown, E.C. Dongol, R. De, Moros, D.A. Alarcon-Rua, J. Perez, V. Stagnaro, Juan P. Alkhawaja, Safaa Jimenez-Alvarez, Luisa F. Cano-Medina, Yuliana A. Valderrama-Beltran, Sandra L. Henao-Rodas, Claudia M. Zuniga-Chavarria, Maria A. El-Kholy, Amani Agha, Hala Sahu, Suneeta Mishra, Shakti B. Bhattacharyya, Mahuya Kharbanda, Mohit Poojary, Aruna Nair, Pravin K. Myatra, Sheila N. Chawla, Rajesh Sandhu, Kavita Mehta, Yatin Rajhans, Prasad Abdellatif-Daboor, Mohammad Chian-Wern, Tai Gan, Chin Seng Mohd-Basri, Mat Nor Aguirre-Avalos, Guadalupe Hernandez-Chena, Blanca E. Sassoe-Gonzalez, Alejandro Villegas-Mota, Isabel Aleman- Bocanegra, Mary C. Bat-Erdene, Ider Carreazo, Nilton Y. Castaneda-Sabogal, Alex Janc, Jarosław Hlinkova, Sona Yildizdas, Dincer Havan, Merve Koker, Alper Sungurtekin, Hulya Dinleyici, Ener C. Guclu, Ertugrul Tao, Lili Memish, Ziad A. Yin, Ruijie |
Keywords: | Antibiotic resistance Developing countries Device-associated infection Health care–associated infection Hospital infection Limited resources countries Low income countries Network Nosocomial infection |
Publisher: | Elsevier Inc. | Abstract: | Background: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden. Methods: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates. These variables were measured at baseline and during the intervention, specifically during the second month, third month, 4 to 16 months, and 17 to 29 months. Comparisons were conducted using a two-sample t test. To explore the exposure-outcome relationship, we used a generalized linear mixed model with a Poisson distribution to model the number of CLABSIs. Results: During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. CLABSI per 1,000 CL-days rates decreased from 15.34 at the baseline period to 7.97 in the 2nd month (relative risk (RR) = 0.52; 95% confidence interval [CI] = 0.48-0.56; P < .001), 5.34 in the 3rd month (RR = 0.35; 95% CI = 0.32-0.38; P < .001), and 2.23 in the 17 to 29 months (RR = 0.15; 95% CI = 0.13-0.17; P < .001). In-ICU all-cause mortality rate decreased from 16.17% at baseline to 13.68% (RR = 0.84; P = .0013) at 17 to 29 months. Conclusions: The implemented approach was effective, and a similar intervention could be applied in other ICUs of low- and middle-income countries to reduce CLABSI and in-ICU all-cause mortality rates. © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. | URI: | https://doi.org/10.1016/j.ajic.2023.12.010 https://hdl.handle.net/11499/56880 |
ISSN: | 0196-6553 |
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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