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).
Medical College of Buenos Aires and Bernal Medical Center, Buenos Aires, Argentina. victor_rosenthal@inicc.org
Victor D
VD
Rosenthal
Dennis G
DG
Maki
Ajita
A
Mehta
Carlos
C
Alvarez-Moreno
Hakan
H
Leblebicioglu
Francisco
F
Higuera
Luis E
LE
Cuellar
Naoufel
N
Madani
Zan
Z
Mitrev
Lourdes
L
Dueñas
Josephine Anne
JA
Navoa-Ng
Humberto Guanche
HG
Garcell
Lul
L
Raka
Rosalía Fernández
RF
Hidalgo
Eduardo A
EA
Medeiros
Souha S
SS
Kanj
Salisu
S
Abubakar
Patricio
P
Nercelles
Ricardo Diez
RD
Pratesi
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