Impact of State Reporting Laws on Central Line-Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units

Six hospitals joined to perform surveillance for central line–associated bloodstream infections outside of intensive care units (ICUs). To facilitate the counting of device-days, a weekly measure of the device use ratio was validated as an estimate of central line–days outside the ICU.

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Impact of International Nosocomial Infection Control Consortium (INICC) Strategy on Central Line–Associated Bloodstream Infection Rates in the Intensive Care Units of 15 Developing Countries

Infection Control and Hospital Epidemiology ◽

10.1086/657140 ◽

2010 ◽

Vol 31 (12) ◽

pp. 1264-1272 ◽

Cited By ~ 97

Author(s):

Victor D. Rosenthal ◽

Dennis G. Maki ◽

Camila Rodrigues ◽

Carlos Álvarez-Moreno ◽

Hakan Leblebicioglu ◽

...

Keyword(s):

Developing Countries ◽

Intensive Care ◽

Nosocomial Infection ◽

Infection Control ◽

Bloodstream Infection ◽

Intensive Care Units ◽

Central Line ◽

Intervention Period ◽

Infection Rates ◽

Education Performance

Background.The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line–associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership.Methods.Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line–days). Process surveillance results at baseline were compared with intervention period data.Results.During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line–days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line–days; relative risk, 0.46 [95% confidence interval, 0.33–0.63]; P <.001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P<.001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001), that adopted Chlorhexidine for antisepsis increased from 7% to 27% (P = .018), and that sought to remove unneeded catheters increased from 37% to 83% (P = .004); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001).Conclusions.Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years.

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Epidemiology of Central Line-Associated Bloodstream Infection (CLABSI) Among Patients in the Intensive Care Units (ICUs) at a Teaching Hospital in Saudi Arabia from Year 2011-2016

Journal of Intensive and Critical Care ◽

10.21767/2471-8505.100105 ◽

2018 ◽

Vol 04 (01) ◽

Cited By ~ 1

Author(s):

N Al Abdullah

Keyword(s):

Saudi Arabia ◽

Intensive Care ◽

Bloodstream Infection ◽

Intensive Care Units ◽

Teaching Hospital ◽

Central Line

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Surveillance Length and Validity of Benchmarks for Central Line-Associated Bloodstream Infection Incidence Rates in Intensive Care Units

PLoS ONE ◽

10.1371/journal.pone.0036582 ◽

2012 ◽

Vol 7 (5) ◽

pp. e36582 ◽

Cited By ~ 2

Author(s):

Patricia S. Fontela ◽

Caroline Quach ◽

David Buckeridge ◽

Madukhar Pai ◽

Robert W. Platt

Keyword(s):

Intensive Care ◽

Bloodstream Infection ◽

Intensive Care Units ◽

Central Line ◽

Incidence Rates ◽

Infection Incidence

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Impact of International Nosocomial Infection Control Consortium’s multidimensional approach on central line–associated bloodstream infection rates in Bahrain

The Journal of Vascular Access ◽

10.1177/1129729819888426 ◽

2019 ◽

Vol 21 (4) ◽

pp. 481-489

Author(s):

Safaa Alkhawaja ◽

Nermeen Kamal Saeed ◽

Victor Daniel Rosenthal ◽

Sana Abdul-Aziz ◽

Ameena Alsayegh ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Nosocomial Infection ◽

Infection Control ◽

Bloodstream Infection ◽

Infection Rate ◽

Bloodstream Infections ◽

Central Line ◽

Multidimensional Approach ◽

Infection Rates

Background: Central line–associated bloodstream infections are serious life-threatening infections in the intensive care unit setting. Methods: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line–associated bloodstream infection rates in Bahrain from January 2013 to December 2016, we conducted a prospective, before-after surveillance, cohort, observational study in one intensive care unit in Bahrain. During baseline, we performed outcome and process surveillance of central line–associated bloodstream infection on 2320 intensive care unit patients, applying Centers for Disease Control and Prevention’s National Healthcare Safety Network definitions. During intervention, we implemented IMA through ISOS, including (1) a bundle of infection prevention interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on central line–associated bloodstream infection rates and consequences, and (6) 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 central line–associated bloodstream infection rate. Results: During baseline, 672 central line days and 7 central line–associated bloodstream infections were recorded, accounting for 10.4 central line–associated bloodstream infections per 1000 central line days. During intervention, 13,020 central line days and 48 central line–associated bloodstream infections were recorded. After the second year, there was a sustained 89% cumulative central line–associated bloodstream infection rate reduction to 1.2 central line–associated bloodstream infections per 1000 central line days (incidence density rate, 0.11; 95% confidence interval 0.1–0.3; p, 0.001). The average extra length of stay of patients with central line–associated bloodstream infection was 23.3 days, and due to the reduction of central line–associated bloodstream infections, 367 days of hospitalization were saved, amounting to a reduction in hospitalization costs of US$1,100,553. Conclusion: Implementing IMA was associated with a significant reduction in the central line–associated bloodstream infection rate in Bahrain.

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