International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008.
We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from 2002 through 2007 in 98 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance System (NNIS) definitions for device-associated health care-associated infection, we collected prospective data from 43,114 patients hospitalized in the Consortium's hospital ICUs for an aggregate of 272,279 days. Although device utilization in the INICC ICUs was remarkably similar to that reported from US ICUs in the CDC's National Healthcare Safety Network, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infections (CLABs) in the INICC ICUs, 9.2 per 1000 CL-days, is nearly 3-fold higher than the 2.4-5.3 per 1000 CL-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia was also far higher, 19.5 vs 1.1-3.6 per 1000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 6.5 versus 3.4-5.2 per 1000 catheter-days. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (80.8% vs 48.1%), Enterobacter species to ceftriaxone (50.8% vs 17.8%), and Pseudomonas aeruginosa to fluoroquinolones (52.4% vs 29.1%) were also far higher in the Consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 14.3% (CLABs) to 27.5% (ventilator-associated pneumonia).
Rosenthal
Victor D
VD
Medical College of Buenos Aires and Bernal Medical Center, Buenos Aires, Argentina. victor_rosenthal@inicc.org
Maki
Dennis G
DG
Mehta
Ajita
A
Alvarez-Moreno
Carlos
C
Leblebicioglu
Hakan
H
Higuera
Francisco
F
Cuellar
Luis E
LE
Madani
Naoufel
N
Mitrev
Zan
Z
Dueñas
Lourdes
L
Navoa-Ng
Josephine Anne
JA
Garcell
Humberto Guanche
HG
Raka
Lul
L
Hidalgo
Rosalía Fernández
RF
Medeiros
Eduardo A
EA
Kanj
Souha S
SS
Abubakar
Salisu
S
Nercelles
Patricio
P
Pratesi
Ricardo Diez
RD
D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D024881:Drug Resistance, Bacterial; D005060:Europe / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology* / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D007362:Intensive Care Units; D007391:International Cooperation; D007843:Latin America / Q000453:epidemiology; D009938:Organizations; D015995:Prevalence