Impact of an infection control program on rates of ventilator-associated pneumonia in intensive care units in 2 Argentinean hospitals

Abstract

Hospitalized, critically ill patients have a significant risk of developing nosocomial infection. Most episodes of nosocomial pneumonia occur in patients undergoing mechanical ventilation (MV). To ascertain the effect of an infection control program on rates of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) in Argentina. All adult patients who received MV for at least 24 hours in 4, level III adult ICUs in 2 Argentinean hospitals were included in the study. A before-after study in which rates of VAP were determined during a period of active surveillance without an infection control program (phase 1) were compared with rates of VAP after implementation of an infection control program that included educational and surveillance feedback components (phase 2). One thousand six hundred thirty-eight MV-days were accumulated in phase 1, and 1520 MV-days were accumulated during phase 2. Rates of VAP were significantly lower in phase 2 than in phase 1 (51.28 vs 35.50 episodes of VAP per 1000 MV-days, respectively, RR = 0.69, 95% CI: 0.49-0.98, P <or= .003). Implementation of a multicomponent infection control program in Argentinean ICUs was associated with significant reductions in rates of VAP.