Rosenthal, Victor Daniel and Yin, Ruijie and Myatra, Sheila Nainan and Memish, Ziad A. and Rodrigues, Camilla and Kharbanda, Mohit and Valderrama-Beltran, Sandra Liliana and Mehta, Yatin and Afeef Al-Ruzzieh, Majeda and Aguirre-Avalos, Guadalupe and Guclu, Ertugrul and Gan, Chin Seng and Jimenez Alvarez, Luisa Fernanda and Chawla, Rajesh and Hlinkova, Sona and Arjun, Rajalakshmi and Agha, Hala Mounir and Chavarria, Maria Adelia Zuniga and Davaadagva, Narangarav and Lai, Yin Hoong and Gomez, Katherine and Aguilar-de-Moros, Daisy and Tai, Chian-Wern and Gonzalez, Alejandro Sassoe and Moreno, Lina Alejandra Aguilar and Sandhu, Kavita and Janc, Jaroslaw and Bocanegra, Mary Cruz Aleman and Yildizdas, Dincer and Medina, Yuliana Andrea Cano and Mota, Maria Isabel Villegas and Omar, Abeer Aly and Duszynska, Wieslawa and El-Kholy, Amani Ali and Alkhawaja, Safaa Abdulaziz and Florin, George Horhat and Medeiros, Eduardo Alexandrino and Tao, Lili and Tumu, Nellie and Elanbya, May Gamar and Dongol, Reshma and Mioljevic, Vesna and Raka, Lul and Duenas, Lourdes and Carreazo, Nilton Yhuri and Dendane, Tarek and Ikram, Aamer and Kardas, Tala and Petrov, Michael M. and Bouziri, Asma and Viet-Hung, Nguyen and Belskiy, Vladislav and Elahi, Naheed and Salgado, Estuardo and Jin, Zhilin (2023) Multinational prospective study of incidence and risk factors for central-line-associated bloodstream infections in 728 intensive care units of 41 Asian, African, Eastern European, Latin American, and Middle Eastern countries over 24 years. Infection Control & Hospital Epidemiology, 44 (11). pp. 1737-1747. ISSN 0899-823X, DOI https://doi.org/10.1017/ice.2023.69.
Full text not available from this repository.Abstract
Objective:To identify central-line (CL)-associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs). Design:From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms. Setting:The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Patients:In total, 278,241 patients followed during 1,815,043 patient days acquired 3,537 CLABSIs. Methods:For the CLABSI rate, we used CL days as the denominator and the number of CLABSIs as the numerator. Using multiple logistic regression, outcomes are shown as adjusted odds ratios (aORs). Results:The pooled CLABSI rate was 4.82 CLABSIs per 1,000 CL days, which is significantly higher than that reported by the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC NHSN). We analyzed 11 variables, and the following variables were independently and significantly associated with CLABSI: length of stay (LOS), risk increasing 3% daily (aOR, 1.03; 95% CI, 1.03-1.04; P < .0001), number of CL days, risk increasing 4% per CL day (aOR, 1.04; 95% CI, 1.03-1.04; P < .0001), surgical hospitalization (aOR, 1.12; 95% CI, 1.03-1.21; P < .0001), tracheostomy use (aOR, 1.52; 95% CI, 1.23-1.88; P < .0001), hospitalization at a publicly owned facility (aOR, 3.04; 95% CI, 2.31-4.01; P <.0001) or at a teaching hospital (aOR, 2.91; 95% CI, 2.22-3.83; P < .0001), hospitalization in a middle-income country (aOR, 2.41; 95% CI, 2.09-2.77; P < .0001). The ICU type with highest risk was adult oncology (aOR, 4.35; 95% CI, 3.11-6.09; P < .0001), followed by pediatric oncology (aOR, 2.51;95% CI, 1.57-3.99; P < .0001), and pediatric (aOR, 2.34; 95% CI, 1.81-3.01; P < .0001). The CL type with the highest risk was internal-jugular (aOR, 3.01; 95% CI, 2.71-3.33; P < .0001), followed by femoral (aOR, 2.29; 95% CI, 1.96-2.68; P < .0001). Peripherally inserted central catheter (PICC) was the CL with the lowest CLABSI risk (aOR, 1.48; 95% CI, 1.02-2.18; P = .04). Conclusions:The following CLABSI risk factors are unlikely to change: country income level, facility ownership, hospitalization type, and ICU type. These findings suggest a focus on reducing LOS, CL days, and tracheostomy; using PICC instead of internal-jugular or femoral CL; and implementing evidence-based CLABSI prevention recommendations.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Control consortium INICC; Central venous catherer; Mortality |
| Subjects: | R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 06 Nov 2025 01:34 |
| Last Modified: | 06 Nov 2025 01:34 |
| URI: | http://eprints.um.edu.my/id/eprint/49819 |
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