Effectiveness of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries - Abstract
Design: A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.
Setting: Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.
Patients: PICU inpatients.
Methods: We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.
Results: During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%.
Conclusions: Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
Written by:
Rosenthal VD, Ramachandran B, Dueñas L, Alvarez-Moreno C, Navoa-Ng JA, Armas-Ruiz A, Ersoz G, Matta-Cortés L, Pawar M, Nevzat-Yalcin A, Rodríguez-Ferrer M, Bran de Casares AC, Linares C, Villanueva VD, Campuzano R, Kaya A, Rendon-Campo LF, Gupta A, Turhan O, Barahona-Guzmán N, de Jesús-Machuca L, Tolentino MC, Mena-Brito J, Kuyucu N, Astudillo Y, Saini N, Gunay N, Sarmiento-Villa G, Gumus E, Lagares-Guzmán A, Dursun O Are you the author?
International Nosocomial Infection Control Consortium, Avenue Corrientes4580,Buenos Aires, Argentina.
Reference: Infect Control Hosp Epidemiol. 2012 Jul;33(7):696-703. Epub 2012 May 24.
PubMed Abstract
PMID: 22669231