title: Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: OBJECTIVE
  To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control strategy including a practice bundle to reduce the rates of central line-associated bloodstream infection (CLAB) in patients hospitalized in pediatric intensive care units (PICUs) of hospitals, which are members of the INICC, from nine cities of five developing countries: Colombia, India, Mexico, Philippines, and Turkey.
  
  
  METHODS
  CLAB rates were determined by means of a prospective surveillance study conducted on 1,986 patients hospitalized in nine PICUs, over a period of 12,774 bed-days. The study was divided into two phases. During Phase 1 (baseline period), active surveillance was performed without the implementation of the multi-faceted approach. CLAB rates obtained in Phase 1 were compared with CLAB rates obtained in Phase 2 (intervention period), after implementation of the INICC multidimensional infection control program.
  
  
  RESULTS
  During Phase 1, 1,029 central line (CL) days were recorded, and during Phase 2, after implementing the CL care bundle and interventions, we recorded 3,861 CL days. The CLAB rate was 10.7 per 1,000 CL days in Phase 1, and in Phase 2, the CLAB rate decreased to 5.2 per 1,000 CL days (relative risk [RR] 0.48, 95% confidence interval [CI] 0.29-0.94, P = 0.02), showing a reduction of 52% in the CLAB rate.
  
  
  CONCLUSIONS
  This study shows that the implementation of a multidimensional infection control strategy was associated with a significant reduction in the CLAB rates in the PICUs of developing countries.
authors.affiliation: International Nosocomial Infection Control Consortium, Corrientes Ave #4580, Floor 11, Apt. A, 1195 Buenos Aires, Argentina. victor_rosenthal@inicc.org
authors.forename: V D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: B
authors.initials: B
authors.lastname: Ramachandran
authors.forename: W
authors.initials: W
authors.lastname: Villamil-Gómez
authors.forename: A
authors.initials: A
authors.lastname: Armas-Ruiz
authors.forename: J A
authors.initials: JA
authors.lastname: Navoa-Ng
authors.forename: L
authors.initials: L
authors.lastname: Matta-Cortés
authors.forename: M
authors.initials: M
authors.lastname: Pawar
authors.forename: A
authors.initials: A
authors.lastname: Nevzat-Yalcin
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Ferrer
authors.forename: R D
authors.initials: RD
authors.lastname: Yıldızdaş
authors.forename: A
authors.initials: A
authors.lastname: Menco
authors.forename: R
authors.initials: R
authors.lastname: Campuzano
authors.forename: V D
authors.initials: VD
authors.lastname: Villanueva
authors.forename: L F
authors.initials: LF
authors.lastname: Rendon-Campo
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: O
authors.initials: O
authors.lastname: Turhan
authors.forename: N
authors.initials: N
authors.lastname: Barahona-Guzmán
authors.forename: O O
authors.initials: OO
authors.lastname: Horoz
authors.forename: P
authors.initials: P
authors.lastname: Arrieta
authors.forename: J M
authors.initials: JM
authors.lastname: Brito
authors.forename: M C V
authors.initials: MC
authors.lastname: Tolentino
authors.forename: Y
authors.initials: Y
authors.lastname: Astudillo
authors.forename: N
authors.initials: N
authors.lastname: Saini
authors.forename: N
authors.initials: N
authors.lastname: Gunay
authors.forename: G
authors.initials: G
authors.lastname: Sarmiento-Villa
authors.forename: E
authors.initials: E
authors.lastname: Gumus
authors.forename: A
authors.initials: A
authors.lastname: Lagares-Guzmán
authors.forename: O
authors.initials: O
authors.lastname: Dursun
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D003906:Developing Countries; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies