International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009 - 23/05/12
, Hu Bijie, MD b, Dennis G. Maki, MD c, Yatin Mehta, MD d, Anucha Apisarnthanarak, MD e, Eduardo A. Medeiros, MD f, Hakan Leblebicioglu, MD g, Dale Fisher, MD h, Carlos Álvarez-Moreno, MD i, Ilham Abu Khader, MD j, Marisela Del Rocío González Martínez, MD k, Luis E. Cuellar, MD l, Josephine Anne Navoa-Ng, MD m, Rédouane Abouqal, MD n, Humberto Guanche Garcell, MD o, Zan Mitrev, MD p, María Catalina Pirez García, MD q, Asma Hamdi, MD r, Lourdes Dueñas, MD s, Elsie Cancel, MD t, Vaidotas Gurskis, MD u, Ossama Rasslan, MD v, Altaf Ahmed, MD w, Souha S. Kanj, MD x, Olber Chavarría Ugalde, RN y, Trudell Mapp, RN z, Lul Raka, MD aa, Cheong Yuet Meng, MD bb, Le Thi Anh Thu, MD cc, Sameeh Ghazal, MD dd, Achilleas Gikas, MD ee, Leonardo Pazmiño Narváez, MD ff, Nepomuceno Mejía, MD gg, Nassya Hadjieva, MD hh, May Osman Gamar Elanbya, MD ii, María Eugenia Guzmán Siritt, MD jj, Kushlani Jayatilleke, MD kkINICC members
Address correspondence to Victor D. Rosenthal, MD, MSc, CIC, International Nosocomial Infection Control Consortium (INICC), Corrientes Ave 4580, Floor 11, Apt A, Buenos Aires 1195, Argentina.Abstract |
The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium’s ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries’ ICUs was remarkably similar to that reported in US ICUs in the CDC’s NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium’s ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia).
Le texte complet de cet article est disponible en PDF.Key Words : Network, Hospital infection, Nosocomial infection, Health care-associated infection, Device-associated infection, Ventilator-associated pneumonia, Catheter-associated urinary tract infection, Central line-associated bloodstream infection, Bloodstream infection, Urinary tract infection, Antibiotic resistance, Developing countries, Limited-resources countries, Low-income countries
Plan
| Victor D. Rosenthal and the Foundation to Fight Against Nosocomial Infections funds all of the activities at INICC headquarters (www.inicc.org). |
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| For a list of the remaining co-authors, members of the International Nosocomial Infection Control Consortium (INICC), see Appendix. |
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| Conflict of interest: None to report. |
Vol 40 - N° 5
P. 396-407 - juin 2012 Retour au numéro
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