title: Device-associated infection rates, device use, length of stay, and mortality in intensive care units of 4 Chinese hospitals: International Nosocomial Control Consortium findings.
abstract: BACKGROUND
  Little data exist on the burden of device-associated health care-associated infection (DA-HAI) in China. This study examined the DA-HAI rate and evaluated its association with device use (DU), length of stay (LOS), and mortality in intensive care units (ICUs) in 4 Chinese hospitals.
  
  
  METHODS
  This was a prospective cohort surveillance study conducted in 7 ICUs in 4 hospitals. We applied International Nosocomial Control Consortium methods and Centers for Disease Control and Prevention (CDC)/National Health and Safety Network (NHSN) definitions to determine rates of central line-associated blood stream infection (CLABSI), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), DU, crude extra length of hospital stay (LOS), and mortality.
  
  
  RESULTS
  Between August 2008 and July 2010, there were a total of 2,631 admissions to the 7 ICUs in the study hospitals. The rate of VAP was 10.46/1,000 mechanical ventilator (MV)-days, the CLABSI rate was 7.66/1,000 central line (CL)-days, and the CAUTI rate was 1.29/1,000 urinary catheter (UC)-days. Pooled DU ratios were 0.43 for MV, 0.71 for CL, and 0.76 for UC. Crude extra LOS was 15 days for patients with CLABSI, 20.5 days for patients with VAP, and 27 days for patients with CAUTI. Crude extra mortality was 14% for patients with CLABSI, 22% for patients with VAP, and 43% for patients with CAUTI.
  
  
  CONCLUSIONS
  In the study ICUs, VAP and CLABSI rates were higher than CDC/NHSN's reported data, and LOS and mortality were increased. Compared with the CDC/NHSN and INICC data, the pooled DU ratio for MV was similar, and DU ratios for CL and UC use ratios were slightly higher.
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.forename: Lili
authors.initials: L
authors.lastname: Tao
authors.forename: Victor D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: Kun
authors.initials: K
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Yun
authors.forename: Yao
authors.initials: Y
authors.lastname: Suo
authors.forename: Xiandong
authors.initials: X
authors.lastname: Gao
authors.forename: Ruisheng
authors.initials: R
authors.lastname: Li
authors.forename: Danxia
authors.initials: D
authors.lastname: Su
authors.forename: Hungmei
authors.initials: H
authors.lastname: Wang
authors.forename: Chunxia
authors.initials: C
authors.lastname: Hao
authors.forename: Wei
authors.initials: W
authors.lastname: Pan
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Saunders
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000401:mortality; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality*; D003906:Developing Countries; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies; D016019:Survival Analysis; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000401:mortality; D055815:Young Adult