Multicenter study in Colombia: Impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central line-associated bloodstream infection rates

Autor: Claudia Janeth Linares-Miranda, Iván Riaño-Forero, Sandra Valderrama-Beltrán, Beatriz E. Ariza-Ayala, María C. Vega-Galvis, Sandra M. Gualtero-Trujillo, María del Socorro Trullo-Escobar, Victor D. Rosenthal, Narda Olarte, Carlos Alvarez-Moreno, Pablo Wenceslao Orellano, Lorena Matta-Cortés, Otto Susmann, Ángela P. Gonzalez-Rubio, Ismael A. Valderrama-Márquez, Jazmín Rodríguez-Peña, Oscar Mancera-Páez, Beatriz E. Mojica-Carreño, Germán García-Laverde, Yamileth Astudillo, Luis F. Rendón-Campo
Rok vydání: 2015
Předmět:
0301 basic medicine
Male
Epidemiology
Ciencias de la Salud
Logistic regression
0302 clinical medicine
Infection control
030212 general & internal medicine
Prospective Studies
Prospective cohort study
LIMITED-RESOURCE COUNTRIES
INCIDENCE DENSITY
Cross Infection
Health Policy
Health services research
Middle Aged
Infectious Diseases
Epidemiological Monitoring
Female
Health Services Research
Adult
medicine.medical_specialty
Catheterization
Central Venous
BUNDLE
CIENCIAS MÉDICAS Y DE LA SALUD
030106 microbiology
HOSPITAL INFECTION
Colombia
LOW-INCOME COUNTRIES
03 medical and health sciences
DEVELOPING COUNTRIES
Young Adult
Intensive care
Sepsis
SURVEILLANCE
medicine
HEALTH CARE–ACQUIRED INFECTION
Humans
Intensive care medicine
Aged
Infection Control
Salud Ocupacional
business.industry
DEVICE-ASSOCIATED INFECTION
Public Health
Environmental and Occupational Health
Nosocomial infection control
Confidence interval
CRITICAL CARE
Controlled Before-After Studies
Relative risk
Catheter-Related Infections
business
Zdroj: American journal of infection control. 44(11)
ISSN: 1527-3296
Popis: Background: The objective of this study was to analyze the impact of a multidimensional infection control approach and the use of the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System on central line–associated bloodstream infection (CLABSI) rates from June 2003-April 2010. Methods: We conducted a prospective, before-after surveillance study of 2,564 patients hospitalized in 4 adult intensive care units (ICUs) and 424 patients in 2 pediatric ICUs of 4 hospitals in 2 cities of Colombia. During baseline, we performed outcome surveillance of CLABSI applying the Centers for Disease Control and Prevention's National Healthcare Safety Network definitions. During intervention, we implemented the INICC multidimensional approach and the ISOS, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate. Results: The baseline rate of 12.9 CLABSIs per 1,000 central line (CL) days, with 3,032 CL days and 39 CLABSIs, was reduced to 3.5 CLABSIs per 1,000 CL days, with 3,686 CL days and 13 CLABSIs, accounting for a 73% CLABSI rate reduction (relative risk, 0.27; 95% confidence interval, 0.14-0.52; P=.002). Conclusions: Implementing the INICC multidimensional infection control approach for CLABSI prevention was associated with a significant reduction in the CLABSI rate of ICUs of Colombia. Fil: Álvarez Moreno, Carlos A.. Universidad Nacional de Colombia; Colombia Fil: Valderrama Beltrán, Sandra L.. Pontificia Universidad Javeriana; Colombia Fil: Rosenthal, Víctor D.. International Nosocomial Infection Control Consortium; Argentina Fil: Mojica Carreño, Beatriz E.. Clínica Nueva; Colombia Fil: Valderrama Márquez, Ismael A.. Hospital El Tunal Ese; Colombia Fil: Matta Cortés, Lorena. Universidad Libre; Colombia Fil: Gualtero Trujillo, Sandra M.. Pontificia Universidad Javeriana; Colombia Fil: Rodríguez Peña, Jazmín. Pontificia Universidad Javeriana; Colombia Fil: Linares Miranda, Claudia J.. Pontificia Universidad Javeriana; Colombia Fil: Gonzalez Rubio, Ángela P.. Pontificia Universidad Javeriana; Colombia Fil: Vega Galvis, María C.. Pontificia Universidad Javeriana; Colombia Fil: Riaño Forero, Iván. Pontificia Universidad Javeriana; Colombia Fil: Ariza Ayala, Beatriz E.. Pontificia Universidad Javeriana; Colombia Fil: García Laverde, Germán. Clínica Nueva; Colombia Fil: Susmann, Otto. Clínica Nueva; Colombia Fil: Mancera Páez, Oscar. Hospital El Tunal Ese; Colombia Fil: Olarte, Narda. Hospital El Tunal Ese; Colombia Fil: Rendón Campo, Luis F.. Universidad Libre; Colombia Fil: Astudillo, Yamileth. Universidad Libre; Colombia Fil: Trullo Escobar, María del Socorro. Universidad Libre; Colombia Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional; Argentina. International Nosocomial Infection Control Consortium; Argentina
Databáze: OpenAIRE
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