title: International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009.
abstract: 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).
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
authors.forename: Victor D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Maki
authors.forename: Silom
authors.initials: S
authors.lastname: Jamulitrat
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Medeiros
authors.forename: Subhash Kumar
authors.initials: SK
authors.lastname: Todi
authors.forename: David Yepes
authors.initials: DY
authors.lastname: Gomez
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
authors.forename: Ilham
authors.initials: I
authors.lastname: Abu Khader
authors.forename: María Guadalupe
authors.initials: MG
authors.lastname: Miranda Novales
authors.forename: Regina
authors.initials: R
authors.lastname: Berba
authors.forename: Fernando Martín
authors.initials: FM
authors.lastname: Ramírez Wong
authors.forename: Amina
authors.initials: A
authors.lastname: Barkat
authors.forename: Osiel Requejo
authors.initials: OR
authors.lastname: Pino
authors.forename: Lourdes
authors.initials: L
authors.lastname: Dueñas
authors.forename: Zan
authors.initials: Z
authors.lastname: Mitrev
authors.forename: Hu
authors.initials: H
authors.lastname: Bijie
authors.forename: Vaidotas
authors.initials: V
authors.lastname: Gurskis
authors.forename: S S
authors.initials: SS
authors.lastname: Kanj
authors.forename: Trudell
authors.initials: T
authors.lastname: Mapp
authors.forename: Rosalía Fernández
authors.initials: RF
authors.lastname: Hidalgo
authors.forename: Nejla
authors.initials: N
authors.lastname: Ben Jaballah
authors.forename: Lul
authors.initials: L
authors.lastname: Raka
authors.forename: Achilleas
authors.initials: A
authors.lastname: Gikas
authors.forename: Altaf
authors.initials: A
authors.lastname: Ahmed
authors.forename: Le Thi Anh
authors.initials: le TA
authors.lastname: Thu
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Guzmán Siritt
mesh_terms: 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