Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/57044
Title: Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East
Authors: Rosenthal, V.D.
Yin, R.
Jin, Z.
Perez, V.
Kis, M.A.
Abdulaziz-Alkhawaja, S.
Valderrama-Beltran, S.L.
Gomez, Katherine
Rodas, Claudia M.H.
El-Sisi, Amal
Sahu, Suneeta
Kharbanda, Mohit
Rodrigues, Camilla
Myatra, Sheila N.
Chawla, Rajesh
Sandhu, Kavita
Mehta, Yatin
Rajhans, Prasad
Arjun, Rajalakshmi
Tai, Chian-Wern
Bhakta, Arpita
Mat Nor, Mohd-Basri
Aguirre-Avalos, Guadalupe
Sassoe-Gonzalez, Alejandro
Bat-Erdene, Ider
Acharya, Subhash P.
Aguilar-de-Moros, Daisy
Carreazo, Nilton Yhuri
Duszynska, Wieslawa
Hlinkova, Sona
Yildizdas, Dincer
Kılıc, Esra K.
Dursun, Oguz
Odek, Caglar
Deniz, Suna S.O.
Guclu, Ertugrul
Koksal, Iftihar
Medeiros, Eduardo A.
Petrov, Michael M.
Tao, Lili
Salgado, Estuardo
Dueñas, Lourdes
Daboor, Mohammad A.
Raka, Lul
Omar, Abeer A.
Ikram, Aamer
Horhat-Florin, George
Memish, Ziad A.
Brown, Eric C.
Keywords: Device-associated infection; Health care–associated infection; Hospital infection; Limited resources countries; Low-income countries
Publisher: Elsevier Inc.
Abstract: Background: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden. Methods: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries. The dependent variable was CAUTI per 1,000 UC days, assessed at baseline and throughout the intervention, in the second month, third month, 4 to 15 months, 16 to 27 months, and 28 to 39 months. Comparisons were made using a 2-sample t test, and the exposure-outcome relationship was explored using a generalized linear mixed model with a Poisson distribution. Results: Over the course of 978,364 patient days, 150,258 patients utilized 652,053 UC-days. The rates of CAUTI per 1,000 UC days were measured. The rates decreased from 14.89 during the baseline period to 5.51 in the second month (risk ratio [RR] = 0.37; 95% confidence interval [CI] = 0.34-0.39; P < .001), 3.79 in the third month (RR = 0.25; 95% CI = 0.23-0.28; P < .001), 2.98 in the 4 to 15 months (RR = 0.21; 95% CI = 0.18-0.22; P < .001), 1.86 in the 16 to 27 months (RR = 0.12; 95% CI = 0.11-0.14; P < .001), and 1.71 in the 28 to 39 months (RR = 0.11; 95% CI = 0.09-0.13; P < .001). Conclusions: Our intervention, without substantial costs or additional staffing, achieved an 89% reduction in CAUTI incidence in ICUs across 32 countries, demonstrating feasibility in ICUs of low- and middle-income countries. © 2024 Association for Professionals in Infection Control and Epidemiology, Inc.
URI: https://doi.org/10.1016/j.ajic.2024.02.017
https://hdl.handle.net/11499/57044
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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