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Impact of an International Nosocomial Infection Control Consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India

2013; Elsevier BV; Volume: 17; Issue: 12 Linguagem: Inglês

10.1016/j.ijid.2013.07.007

1878-3511

Namita Jaggi, Camilla Rodrigues, Víctor Rosenthal, Subhash Todi, Sweta Shah, Narinder Kumar Saini, Arpita Dwivedy, Farokh Udwadia, Preeti Mehta, Murali Chakravarthy, Sanjeev Singh, Samir Sahu, Deepak Govil, Ashit Hegd, Farahad Kapadia, Arpita Bhakta, Mahuya Bhattacharyya, Tanu Singhal, Reshma Naik, Vatsal Kothari, Amit Gupta, Suvin Shetty, Sheena Binu, Preethi Pinto, Aruna Poojary, Geeta Koppikar, Lata Bhandarkar, Shital Jadhav, Neeraj Chavan, Shweta Bahirune, Shilpa Durgad, Gita Nataraj, Pallavi Surase, B.N. Gokul, R. Sukanya, Leema Pushparaj, Kavitha Radhakrishnan,

Antibiotic Use and Resistance

ObjectiveTo evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India.MethodsThis was a prospective, before-and-after cohort study of 35 650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods.ResultsDuring the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80 898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31–0.70; p = 0.0001).ConclusionsImplementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up.