Six-year study on peripheral venous catheter–associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings

2020 ◽  
pp. 112972982091725
Author(s):  
Víctor Daniel Rosenthal ◽  
Ider Bat-Erdene ◽  
Debkishore Gupta ◽  
Prasad Rajhans ◽  
Sheila Nainan Myatra ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
East Asia ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
South East Asia ◽  
Short Term ◽  
Peripheral Venous Catheter ◽  
East Asia Region

Background: Short-term peripheral venous catheter–associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter–associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available. Methods: Prospective, surveillance study on peripheral venous catheter–associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. Results: We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter–associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter–associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter–associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter–associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter–associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%). Conclusions: Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter–associated bloodstream infections.

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings

2020 ◽  
Vol 41 (5) ◽  
pp. 553-563 ◽  
Author(s):  
Víctor Daniel Rosenthal ◽  
Ider Bat-Erdene ◽  
Debkishore Gupta ◽  
Souad Belkebir ◽  
Prasad Rajhans ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Nosocomial Infection ◽  
Eastern Mediterranean ◽  
Venous Catheter ◽  
South East Asia ◽  
Short Term ◽  
Peripheral Venous Catheter ◽  
Resource Limited ◽  
Mediterranean Europe

AbstractBackground:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).Conclusions:PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

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

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.

An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)

2021 ◽  
pp. 1-7
Author(s):  
Victor Daniel Rosenthal ◽  
Gustavo Jorge Chaparro ◽  
Eduardo Alexandrino Servolo-Medeiros ◽  
Dayana Souza-Fram ◽  
Daniela Vieira da Silva Escudero ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Latin America ◽  
Intensive Care ◽  
Costa Rica ◽  
Dominican Republic ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Intravenous Catheter ◽  
Short Term ◽  
Peripheral Intravenous Catheter

Abstract Background: Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied. Methods: International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used. Results: In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040). The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%. Conclusions: Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

2003 ◽  
Vol 24 (7) ◽  
pp. 501-505 ◽  
Author(s):  
Irina Zuschneid ◽  
Frank Schwab ◽  
Christine Geffers ◽  
Henning Rüden ◽  
Petra Gastmeier
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Relative Reduction ◽  
Central Venous ◽  
Infection Surveillance

AbstractBackground And Objective:The German Nosocomial Infection Surveillance System (KISS) began in 1997 as a nationwide surveillance project for voluntary registration of nosocomial infections in intensive care units (ICUs). This study investigates trends in the rates of central venous catheter (CVC)–associated primary bloodstream infections (BSIs) in ICUs since participation in KISS.Methods:Eighty-four ICUs that had participated in KISS for at least 24 months were considered for more detailed analysis. Monthly rates of primary BSI for the 84 ICUs were pooled for the 24 months. The best model for describing the curve of reduction was sought. Additionally, incidence densities were compared using the z test.Results:For the 212 ICUs participating, a relative 25.7% decrease (from 2.1 to 1.6 primary BSIs per 1,000 CVC-days) was observed from January 1997 to June 2001. The 84 ICUs that participated in KISS for a minimum of 24 months accumulated 552,359 patient-days and 404,897 CVC-days during their 24 months. A linear regression model was selected to explain the curve of primary BSI reduction in the 84 ICUs. It showed a decrease from 2.1 to 1.5 primary BSIs per 1,000 CVC-days, meaning an overall relative reduction of 28.6% during the 2-year observation period. These results were significant (Student's t test for the monthly reduction coefficient; P = .04). The reduction of primary BSIs was shown for both clinical sepsis and laboratory-confirmed, CVC-associated primary BSIs.Conclusion:Performing surveillance with KISS was associated with a reduction of the rates of CVC-associated primary BSIs in ICU patients (Infect Control Hosp Epidemiol 2003;24:501-505).

scholarly journals Short-Term Peripheral Venous Catheter-Related Bloodstream Infections: Evidence for Increasing Prevalence of Gram-Negative Microorganisms from a 25-Year Prospective Observational Study

2018 ◽  
Vol 62 (11) ◽  
Author(s):  
Marco Ripa ◽  
Laura Morata ◽  
Olga Rodríguez-Núñez ◽  
Celia Cardozo ◽  
Pedro Puerta-Alcalde ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Antimicrobial Treatment ◽  
Beta Lactams ◽  
Short Term ◽  
Gram Negative ◽  
Peripheral Venous Catheter ◽  
Factors Associated

ABSTRACT The aim of this study was to describe the etiology and outcome of short-term peripheral venous catheter (PVC)-related bloodstream infections (PVCRBSI) in a 25-year period (1992 to 2016) and to identify predictive factors of Gram-negative PVCRBSI. This was a prospective observational study including all episodes of PVCRBSI. A multivariate logistic regression model adjusted for calendar year was built to explore factors associated with a Gram-negative bacterial etiology. Over the study period, 711 episodes of PVCRBSI were identified. Incidence rate of PVCRBSI increased from 0.06 to 0.13 episodes/1,000 patient-days. A Gram-negative bacterial etiology was demonstrated in 162 (22.8%) episodes. There was a significant increase in the proportion of Gram-negative infections (22.6% in 1992 to 1996 versus 33.2% in 2012 to 2016). Independent predictive factors of Gram-negative PVCRBSI were the following: being in the hospital for more than 7 days with a catheter in situ for more than 3 days (adjusted odds ratio [aOR], 1.80; 95% confidence interval [CI], 1.20 to 2.69), surgery in the previous month (aOR, 2.39; 95% CI, 1.40 to 4.09), and antimicrobial treatment with beta-lactams (aOR, 1.80; 95% CI, 1.16 to 2.78). In conclusion, we reported an increase in the prevalence of Gram-negative PVCRBSI over the last 25 years. Factors associated with a Gram-negative bacterial etiology were being in the hospital for more than 7 days with a catheter in situ for more than 3 days, having undergone surgery, and having received antimicrobial treatment with beta-lactams.

scholarly journals Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017

2019 ◽  
Vol 24 (5) ◽  
Author(s):  
Simone Iacchini ◽  
Michela Sabbatucci ◽  
Carlo Gagliotti ◽  
Gian Maria Rossolini ◽  
Maria Luisa Moro ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Individual Characteristics ◽  
National Surveillance ◽  
Peripheral Venous Catheter ◽  
Nationwide Surveillance ◽  
Tract Infections ◽  
Almost All

Following the rapid increase of infections due to carbapenemase-producing Enterobacteriaceae (CPE) in Italy, the national surveillance of bloodstream infections (BSI) due to CPE (Klebsiella pneumoniae and Escherichia coli) was instituted in 2013. All CPE-BSI cases reported to the surveillance in the years 2014–17 were analysed in order to investigate incidence rate (IR), trend, main individual characteristics and enzymes involved in CPE resistance. Throughout this period, 7,632 CPE-BSI cases (IR: 3.14/100,000 inhabitants) were reported from all 21 regions and autonomous provinces in Italy, with an increasing number of reported cases (2014: 1,403; 2015: 1,838; 2016: 2,183; 2017: 2,208). CPE-BSI cases mainly occurred in subjects aged over 60 years (70.9%) and more frequently in males (62.7%) than in females. Most of the cases originated in hospitals (87.2%), mainly in intensive care units (38.0%), and were associated with central or peripheral venous catheter use (23.9%) or with urinary tract infections (21.1%). Almost all CPE-BSI (98.1%) were due to K. pneumoniae carrying the K. pneumoniae carbapenemase (KPC) enzyme (95.2%). These data show that carbapenemase-producing K. pneumoniae are endemic in our country, causing a high number of BSI and representing a threat to patient safety.

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