Abstract
BackgroundDevice-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012.MethodsA DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods.ResultsWe collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI).ConclusionsDA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.
Highlights
Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, in the intensive care unit (ICU)
DA-HAI rates and device use (DU) ratios in our ICUs were higher than those reported in the Infection Control Consortium (INICC) global report and in the US National Healthcare Safety Network (NHSN) report
In adult and paediatric patients, we found higher rates of central line-associated bloodstream infections (CLABSIs) in the largest hospitals (>500 beds), ventilator-associated pneumonias (VAPs) and catheter-associated urinary tract infections (CAUTIs) rates were higher in middle-sized hospitals (201–1000 beds)
Summary
Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, in the intensive care unit (ICU). The INICC has the following goals: To create a dynamic global network of hospitals worldwide and conduct surveillance of DA-HAIs and SSIs using standardized definitions and established methodologies, to promote the implementation of evidence-based infection control practices, and to carry out applied infection control research; to provide training and surveillance tools to individual hospitals which can allow them to conduct outcome and process surveillance of DA-HAIs and SSIs, to measure their consequences, and assess the impact of infection control practices; to improve the safety and quality of healthcare world-wide through the implementation of systematized programmes to reduce rates of DA-HAIs and SSIs, their associated mortality, excess lengths of stay (LOS), excess costs, antibiotic usage, and bacterial resistance [8]
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