title: Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: findings of the International Nosocomial Infection Control Consortium.
abstract: OBJECTIVE
  The aim of this study was to analyze the impact of a multidimensional infection control approach on the reduction of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) patients of one hospital in China.
  
  
  METHODS
  We conducted a before-after study from January 2005 to July 2009, which was divided into baseline (phase 1) and intervention (phase 2) periods. During phase 1, active prospective outcome surveillance of VAP was performed by applying the definitions of the Centers for Disease Control and Prevention/National Health Safety Network, and the methodology of the International Nosocomial Infection Control Consortium. During phase 2, the multidimensional approach was implemented. Ventilator-associated pneumonia rates obtained in phases 1 and 2 were compared in yearly periods.
  
  
  RESULTS
  We recorded data from 16,429 patients hospitalized in 3 ICUs, for a total of 74,116 ICU bed days. The VAP baseline rate was 24.1 per 1000 ventilator-days. During phase 2, the VAP rate significantly decreased to 5.7 per 1000 ventilator-days in 2009 (2009 vs 2005: relative risk, 0.31; 95% confidence interval, 0.16-0.36; P = .0001), amounting to a 79% cumulative VAP rate reduction.
  
  
  CONCLUSIONS
  Implementing a multidimensional infection control intervention for VAP was associated with a significant cumulative reduction in the VAP rate in our ICUs.
authors.affiliation: Department of Respiratory Medicine, Huadong Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Tao
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.forename: Victor Daniel
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Gao
authors.forename: Lixian
authors.initials: L
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007318:Inservice Training / Q000458:organization & administration; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation