International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009.
We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).
Rosenthal
Victor D
VD
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
Maki
Dennis G
DG
Jamulitrat
Silom
S
Medeiros
Eduardo A
EA
Todi
Subhash Kumar
SK
Gomez
David Yepes
DY
Leblebicioglu
Hakan
H
Abu Khader
Ilham
I
Miranda Novales
María Guadalupe
MG
Berba
Regina
R
Ramírez Wong
Fernando Martín
FM
Barkat
Amina
A
Pino
Osiel Requejo
OR
Dueñas
Lourdes
L
Mitrev
Zan
Z
Bijie
Hu
H
Gurskis
Vaidotas
V
Kanj
S S
SS
Mapp
Trudell
T
Hidalgo
Rosalía Fernández
RF
Ben Jaballah
Nejla
N
Raka
Lul
L
Gikas
Achilleas
A
Ahmed
Altaf
A
Thu
Le Thi Anh
le TA
Guzmán Siritt
María Eugenia
ME
D000328:Adult; D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007843:Latin America / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult