Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC)

• DOI: 10.1007/s15010-012-0246-5
• Publication Date: 2012-02-27T14:29:22Z
• Authors: V. D. Rosenthal; B. Ramachandran; W. Villamil-Gómez; A. Armas-Ruiz; J. A. Navoa-Ng; L. Matta-Cortés; M. Pawar; A. Nevzat-Yalcin; M. Rodríguez-Ferrer; R. D. Yıldızdaş; A. Menco; R. Campuzano; V. D. Villanueva; L. F. Rendon-Campo; A. Gupta; O. Turhan; N. Barahona-Guzmán; O. O. Horoz; P. Arrieta; J. M. Brito; M. C. V. Tolentino; Y. Astudillo; N. Saini; N. Gunay; G. Sarmiento-Villa; E. Gumus; A. Lagares-Guzmán; O. Dursun
• Keywords: Male; 0301 basic medicine; Catheterization, Central Venous; Adolescent; Bacteremia; Intensive Care Units, Pediatric; Developing countries; 03 medical and health sciences; Humans; Prospective Studies; Child; Developing Countries; Cross Infection; Infection Control; Catheter-related infections; 1. No poverty; Multidimensional approach; 3. Good health; Bundle; International Nosocomial Infection Control Consortium; Catheter-Related Infections; Child, Preschool; Female; Hand hygiene

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control strategy including a practice bundle to reduce the rates of central line-associated bloodstream infection (CLAB) in patients hospitalized in pediatric intensive care units (PICUs) of hospitals, which are members of the INICC, from nine cities of five developing countries: Colombia, India, Mexico, Philippines, and Turkey.CLAB rates were determined by means of a prospective surveillance study conducted on 1,986 patients hospitalized in nine PICUs, over a period of 12,774 bed-days. The study was divided into two phases. During Phase 1 (baseline period), active surveillance was performed without the implementation of the multi-faceted approach. CLAB rates obtained in Phase 1 were compared with CLAB rates obtained in Phase 2 (intervention period), after implementation of the INICC multidimensional infection control program.During Phase 1, 1,029 central line (CL) days were recorded, and during Phase 2, after implementing the CL care bundle and interventions, we recorded 3,861 CL days. The CLAB rate was 10.7 per 1,000 CL days in Phase 1, and in Phase 2, the CLAB rate decreased to 5.2 per 1,000 CL days (relative risk [RR] 0.48, 95% confidence interval [CI] 0.29-0.94, P = 0.02), showing a reduction of 52% in the CLAB rate.This study shows that the implementation of a multidimensional infection control strategy was associated with a significant reduction in the CLAB rates in the PICUs of developing countries.