Rosenthal, Victor D. and Jin, Zhilin and Brown, Eric C. and Dongol, Reshma and De Moros, Daisy A. and Alarcon-Rua, Johana and Perez, Valentina and Stagnaro, Juan P. and Alkhawaja, Safaa and Jimenez-Alvarez, Luisa F. and Cano-Medina, Yuliana A. and Valderrama-Beltran, Sandra L. and Henao-Rodas, Claudia M. and Zuniga-Chavarria, Maria A. and El-Kholy, Amani and Agha, Hala and Sahu, Suneeta and Mishra, Shakti B. and Bhattacharyya, Mahuya and Kharbanda, Mohit and Poojary, Aruna and Nair, Pravin K. and Myatra, Sheila N. and Chawla, Rajesh and Sandhu, Kavita and Mehta, Yatin and Rajhans, Prasad and Abdellatif-Daboor, Mohammad and Chian-Wern, Tai and Gan, Chin Seng and Mohd-Basri, Mat Nor and Aguirre-Avalos, Guadalupe and Hernandez-Chena, Blanca E. and Sassoe-Gonzalez, Alejandro and Villegas-Mota, Isabel and Aleman-Bocanegra, Mary C. and Bat-Erdene, Ider and Carreazo, Nilton Y. and Castaneda-Sabogal, Alex and Janc, Jaroslaw and Hlinkova, Sona and Yildizdas, Dincer and Havan, Merve and Koker, Alper and Sungurtekin, Hulya and Dinleyici, Ener C. and Guclu, Ertugrul and Tao, Lili and Memish, Ziad A. and Yin, Ruijie (2024) Decreasing central line-associated bloodstream infections rates in intensive care units in 30 low- and middle-income countries: An INICC approach. American Journal Of Infection Control, 52 (5). pp. 580-587. ISSN 0196-6553, DOI https://doi.org/10.1016/j.ajic.2023.12.010.
Full text not available from this repository.Abstract
Background: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden. Methods: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates. These variables were measured at baseline and during the intervention, specifically during the second month, third month, 4 to 16 months, and 17 to 29 months. Comparisons were conducted using a two-sample t test. To explore the exposure-outcome relationship, we used a generalized linear mixed model with a Poisson distribution to model the number of CLABSIs. Results: During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. CLABSI per 1,000 CL-days rates decreased from 15.34 at the baseline period to 7.97 in the 2nd month (relative risk (RR) = 0.52; 95% confidence interval CI] = 0.48-0.56; P < .001), 5.34 in the 3rd month (RR = 0.35; 95% CI = 0.32-0.38; P < .001), and 2.23 in the 17 to 29 months (RR = 0.15; 95% CI = 0.13-0.17; P < .001). In-ICU all-cause mortality rate decreased from 16.17% at baseline to 13.68% (RR = 0.84; P = .0013) at 17 to 29 months. Conclusions: The implemented approach was effective, and a similar intervention could be applied in other ICUs of low- and middle-income countries to reduce CLABSI and in-ICU all-cause mortality rates. (c) 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Hospital infection; Nosocomial infection; Health care-associated infection; Device-associated infection; Antibiotic resistance; Developing countries; Limited resources countries; Low income countries; Network |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 09 Jan 2025 03:41 |
| Last Modified: | 09 Jan 2025 03:41 |
| URI: | http://eprints.um.edu.my/id/eprint/46979 |
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