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Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

2018; Elsevier BV; Volume: 11; Issue: 5 Linguagem: Inglês

10.1016/j.jiph.2018.06.002

1876-035X

Hail M. Al-Abdely, Yassir Khidir Mohammed, Víctor Rosenthal, Pablo Orellano, Mohamed Al-Azhary, E. Kaid, Anan Al-Attas, Ghadeer Hawsawi, Ashraf Kelany, Bedoor Hussein, Bayan Esam, Rami Altowerqi, Modhi A. Alkamaly, Nader Ahmad Tawfic, Elinita Cruzpero, Raya M. Al Rashidi, Reny Thomas, Apsia Musa Molano, Hessa A. Al Enazy, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Sharifa Alatawi, Raslan Nakhla, Fatma Mohammad Al Adwani, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Hanan Hanafy Diab, Nahla A. Kader, Ibtesam Yahia Hassan Assiry, Fahad A. Sawan, Hassan E. Ammari, Alhasan M. Mashiakhy, Elaine B. Santiago, Christian M.S. Chua, Imee M. Dalis, Haider M. Arishi, Ruthelma Lozada, Ibrahim A.M. Al-Zaydani Asiri, Hala Ahmed, A. Al Jarie, Ali S.M. Al-Qathani, Halima Y. Al-Alkami, M. AlDalaton, Siti J.B. Alih, M.J. Alaliany, Najla J. Helali, Grace Sindayen, Annalyn Amor Malificio, Haya Barjas Al Dossari, Abdulmajid Ghowaizi Algethami, Dia Mohamed, Leigh Yanne, Avigail Tan, Sheema Babu, Shatha Mohammad Abduljabbar, Hala Rushdi, Janice Fernandez, Waleed Hussain, Renuga D. Rajavel, Syed Z Bukhari, Abdullah Turkistani, Jeyashri Jaji Mushtaq, Eida Albeladi, Sally Aboushoushah, Nahed Qushmaq, Leide Shyrine, Jomol Philipose, Mohamed Raees, Nawal S. Abdulkhalik, Marjory Madco, Mohd Abdulghany, Athena Manao, Catherine Acostan, Rania Safwat, Muhammad A. Halwani, N Abdel Aal, Anumol Thomas, Shaymaa M. Abdulatif, Nelia C. Ariola, Aisha H. Mutwalli, Nelia C. Ariola, Eatedal Bohlega, Saly Simon, Estelita Damlig, Sherin G. Elsherbini, Ilama T. Krishne, Sheela B. Abraham, Mohammed A. Ali Karrar, Nisreen A. Gosn, Abdulaziz A. Al Hindi, Rasha N. Jaha, Saeda M. AlQahtani, Ali Omer Abdul Aziz, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Mohammed Abdullah Al Raey, Saeed Ali Al Darani, Misbah Rehman Aziz, Batool Al Manea, Eslam Samy, Solita Briones, Radhika Krishnan, Saman S.M. Raees, K. Susmeena Tabassum, Khalid Ghalilah, Mohamed Alradady, Abdulrahim Al Qatri, Mafaten Chaouali, Magdy Elsisi, Hajer A. Aldossary, S. Al-Suliman, Amina A. Al Talib, N. Albaghly, Mohammad E. Haqlre Mia, Manal Algethamy, Dhafer M. Alamri, Adnan S. Al-Saadi, Evelyn P. Ayugat, Nawaf A. Al Hazazi, Modi I. Al Hussain, Yvonne Caminade, Ann J. Santos, Mohamed H. Abdulwahab, Bushra T.A. Al-Garni,

Antibiotic Use and Resistance

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia.