Infection Control Program for MRSA in Intensive Care Units

Design.Before-after prospective surveillance study to assess the efficacy of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control program to reduce the rate of occurrence of ventilator-associated pneumonia (VAP).Setting.Neonatal intensive care units (NICUs) of INICC member hospitals from 15 cities in the following 10 developing countries: Argentina, Colombia, El Salvador, India, Mexico, Morocco, Peru, Philippines, Tunisia, and Turkey.Patients.NICU inpatients.Methods.VAP rates were determined during a first period of active surveillance without the implementation of the multidimensional approach (phase 1) to be then compared with VAP rates after implementation of the INICC multidimensional infection control program (phase 2), which included the following practices: a bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices. This study was conducted by infection control professionals who applied National Health Safety Network (NHSN) definitions for healthcare-associated infections and INICC surveillance methodology.Results.During phase 1, we recorded 3,153 mechanical ventilation (MV)–days, and during phase 2, after the implementation of the bundle of interventions, we recorded 15,981 MV-days. The VAP rate was 17.8 cases per 1,000 MV-days during phase 1 and 12.0 cases per 1,000 MV-days during phase 2 (relative risk, 0.67 [95% confidence interval, 0.50–0.91]; P = .001 ), indicating a 33% reduction in VAP rate.Conclusions.Our results demonstrate that an implementation of the INICC multidimensional infection control program was associated with a significant reduction in VAP rate in NICUs in developing countries.

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Efficacy of an infection control program in reducing ventilator-associated pneumonia in a Chinese neonatal intensive care unit

American Journal of Infection Control ◽

10.1016/j.ajic.2013.06.007 ◽

2013 ◽

Vol 41 (11) ◽

pp. 1059-1064 ◽

Cited By ~ 15

Author(s):

Qi Zhou ◽

Shoo K. Lee ◽

Si-yuan Jiang ◽

Chao Chen ◽

Majeeda Kamaluddeen ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Infection Control ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Control Program ◽

Ventilator Associated Pneumonia ◽

Infection Control Program

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Hospital-Acquired Infections in Intensive Care Unit Patients An Overview with Emphasis on Epidemics

Infection Control ◽

10.1017/s0195941700059774 ◽

1983 ◽

Vol 4 (5) ◽

pp. 371-375 ◽

Cited By ~ 180

Author(s):

Richard P Wenzel ◽

Robert L. Thompson ◽

Sandra M. Landry ◽

Brenda S. Russell ◽

Patti J. Miller ◽

...

Keyword(s):

Intensive Care ◽

Infection Control ◽

Nosocomial Infections ◽

Hospital Admissions ◽

Bloodstream Infections ◽

Control Program ◽

University Of Virginia ◽

Icu Patients ◽

Infection Control Program ◽

The University

AbstractSurveillance activities for the detection of nosocomial infections at the University of Virginia Hospital (Charlottesville, Virginia) and at hospitals participating in the Virginia Statewide Infection Control Program have focused on outbreaks and device-related infections which are potentially preventable. Eleven outbreaks of nosocomial infections were identified at the University of Virginia Hospital between January 1, 1978 and December 31, 1982 (9.8 outbreaks/100,000 admissions). Ten of the 11 were centered in critical care units. The 269 patients involved in the epidemics represented 0.2% of all hospital admissions and 3.7% of all patients who developed nosocomial infections. Eight of the 11 outbreaks involved infection of the bloodstream, and the 90 patients who developed a bloodstream infection as part of an epidemic represented 8% of all patients with nosocomial bloodstream infections identified during the five-year study period. The reservoir of the 11 outbreaks involved devices (5), contaminated cocaine (1), probable blood products (1), other patients (3), and nursing personnel (1). Forty-one percent of all nosocomial bloodstream infections and 41% of all nosocomial pneumonias occurred in intensive care units (ICUs).In 38 hospitals in the state of Virginia with ICUs and practitioners who voluntarily reported surveillance data between June 1,1980 and May 31,1982, there were 264,757 patients admitted and a crude infection rate of 3%. Of note is that 1,867 of the 7,407 nosocomial infections (25%) occurred in the ICU patients. Several factors point to a compelling argument that the highest priority in infection control resources be assigned to the prevention and control of ICU infections: ICU patients often have serious device-related infections and may be identified as high risk prior to infection. Furthermore, they are at risk of being infected as part of a major outbreak. Such characteristics define a population of hospitalized patients, many of whose infections are preventable.

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Impact of an Infection Control Program in an Intensive Care Unit in France

Infection Control and Hospital Epidemiology ◽

10.1086/499150 ◽

2006 ◽

Vol 27 (1) ◽

pp. 60-66 ◽

Cited By ~ 12

Author(s):

Régis Verdier ◽

Sylvie Parer ◽

Hélène Jean-Pierre ◽

Pierre Dujols ◽

Marie-Christine Picot

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Rate ◽

Infection Control ◽

Nosocomial Pneumonia ◽

Control Program ◽

Multidrug Resistant ◽

Infection Control Program ◽

Period 2 ◽

Multidrug Resistant Pathogens

Objective.To evaluate the impact of an infection control program in an intensive care unit (ICU).Design.Prospective before-after study. Two 6-month study periods were compared; between these periods, an infection control program based on isolation was implemented.Setting.Polyvalent ICU of Montpellier Teaching Hospital.Patients.Any patient who was hospitalized in the ICU for >48 hours and was discharged during 1 of the 2 periods.Main Outcome Measures.The main patient-related variables were sex, age at admission, type of patient (surgical, medical, or trauma), Simplified Acute Physiology Score II, length of ICU stay, need for intubation, duration of exposure to invasive devices, onset of nosocomial infection and pathogens responsible, and death. We compared the 2 study periods with respect to the incidence of 4 nosocomial infections (pneumonia, urinary tract infection, bacteremia, and catheter-associated infection), the frequency of infection with the main multidrug-resistant pathogens, and patient survival.Results.Patients in periods 1 and 2 were similar with regard to sex, age, physiology score, and exposure to invasive devices. The rates of infection with multidrug-resistant pathogens were significandy lower during period 2 than during period 1 (infection rate: 28.1% of patients in period 1 and 9.6% of patients in period 2 [P = .01]; pneumonia rate: 32.6% of patients in period 1 and 4.2% of patients in period 2 [P = .008]). The mortality rate among patients with nosocomial pneumonia was 38.2% in period 1 and 4.3% in period 2 (P = .009).Conclusions.After implementation of an infection control program, the rate of infection with multidrug-resistant pathogens decreased, as did the mortality rate among patients with nosocomial pneumonia.

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