Please use this identifier to cite or link to this item: 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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