Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of ventilator-associated pneumonia in intensive care units of two hospitals in Kuwait.

Autor:	Al-Mousa HH; Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait., Omar AA; Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait., Rosenthal VD; International Nosocomial Infection Control Consortium, Buenos Aires, Argentina., Salama MF; Mubarak Al Kabir Hospital, Kuwait City, Kuwait.; Microbiology and Medical Immunology Department, Mansoura Faculty of Medicine, University of Mansoura, Egypt., Aly NY; Farwaniya Hospital, Kuwait City, Kuwait.; Department of Tropical Medicine and Hygiene, Faculty of Medicine, University of Alexandria, Alexandria, Egypt., El-Dossoky Noweir M; Farwaniya Hospital, Kuwait City, Kuwait., Rebello FM; Mubarak Al Kabir Hospital, Kuwait City, Kuwait., Narciso DM; Mubarak Al Kabir Hospital, Kuwait City, Kuwait., Sayed AF; Farwaniya Hospital, Kuwait City, Kuwait., Kurian A; Farwaniya Hospital, Kuwait City, Kuwait., George SM; Farwaniya Hospital, Kuwait City, Kuwait., Mohamed AM; Farwaniya Hospital, Kuwait City, Kuwait., Ramapurath RJ; Farwaniya Hospital, Kuwait City, Kuwait., Varghese ST; Farwaniya Hospital, Kuwait City, Kuwait., Orellano PW; International Nosocomial Infection Control Consortium, Buenos Aires, Argentina.; Universidad Tecnológica Nacional, Facultad Regional San Nicolás and Consejo Nacional de Investigaciones Científicas y Técnicas, San Nicolás, Argentina.
Jazyk:	angličtina
Zdroj:	Journal of infection prevention [J Infect Prev] 2018 Jul; Vol. 19 (4), pp. 168-176. Date of Electronic Publication: 2018 Mar 23.
DOI:	10.1177/1757177418759745
Abstrakt:	Objective: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in three intensive care units (ICUs) from two hospitals in Kuwait City from January 2014 to March 2015. Design: A prospective, before-after study on 2507 adult ICU patients. During baseline, we performed outcome surveillance of VAP applying CDC/NHSN definitions. During intervention, we implemented the IMA through the INICC Surveillance Online System (ISOS), which included: (1) a bundle of infection prevention interventions; (2) education; (3) outcome surveillance; and (4) feedback on VAP rates and consequences. Logistic regression analysis was performed to estimate the effect of the intervention on VAP, controlling for potential bias. Results: During baseline, 1990 mechanical ventilator (MV)-days and 14 VAPs were recorded, accounting for 7.0 VAPs per 1000 MV-days. During intervention, 9786 MV-days and 35 VAPs were recorded, accounting for 3.0 VAPs per 1000 MV-days. The VAP rate was reduced by 57.1% (incidence-density ratio = 0.51; 95% CI = 0.28-0.93; p = 0.042). Logistic regression showed a significant reduction in VAP rate during the intervention phase (OR = 0.39, 95% CI = 0.18-0.83), with 61% effectiveness. Conclusions: Implementing IMA through ISOS was associated with a significant reduction in the VAP rate in Kuwait ICUs. Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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