title: Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries.
  
  
  METHODS
  This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology.
  
  
  RESULTS
  During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate.
  
  
  CONCLUSIONS
  Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
authors: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
authors: Victor D
authors: VD
authors: Rosenthal
authors: Carlos
authors: C
authors: Álvarez-Moreno
authors: Wilmer
authors: W
authors: Villamil-Gómez
authors: Sanjeev
authors: S
authors: Singh
authors: Bala
authors: B
authors: Ramachandran
authors: Josephine A
authors: JA
authors: Navoa-Ng
authors: Lourdes
authors: L
authors: Dueñas
authors: Ata N
authors: AN
authors: Yalcin
authors: Gulden
authors: G
authors: Ersoz
authors: Antonio
authors: A
authors: Menco
authors: Patrick
authors: P
authors: Arrieta
authors: Ana C
authors: AC
authors: Bran-de Casares
authors: Lilian
authors: L
authors: de Jesus Machuca
authors: Kavitha
authors: K
authors: Radhakrishnan
authors: Victoria D
authors: VD
authors: Villanueva
authors: Maria C V
authors: MC
authors: Tolentino
authors: Ozge
authors: O
authors: Turhan
authors: Sevim
authors: S
authors: Keskin
authors: Eylul
authors: E
authors: Gumus
authors: Oguz
authors: O
authors: Dursun
authors: Ali
authors: A
authors: Kaya
authors: Necdet
authors: N
authors: Kuyucu
mesh_terms: D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods*; D015278:Intensive Care Units, Pediatric; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D015995:Prevalence