title: Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 21 adult intensive-care units from 10 cities in India: findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: We report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divided into baseline and intervention periods. During baseline, prospective surveillance of VAP was performed applying the Centers for Disease Control and Prevention/National Healthcare Safety Network definitions and INICC methods. During intervention, our approach in each ICU included a bundle of interventions, education, outcome and process surveillance, and feedback of VAP rates and performance. Crude stratified rates were calculated, and by using random-effects Poisson regression to allow for clustering by ICU, the incidence rate ratio for each time period compared with the 3-month baseline was determined. The VAP rate was 17.43/1000 mechanical ventilator days during baseline, and 10.81 for intervention, showing a 38% VAP rate reduction (relative risk 0.62, 95% confidence interval 0.5-0.78, P = 0.0001).
authors.affiliation: Medanta The Medicity, New Delhi, India.
authors.forename: Y
authors.initials: Y
authors.lastname: Mehta
authors.forename: N
authors.initials: N
authors.lastname: Jaggi
authors.forename: V D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: C
authors.initials: C
authors.lastname: Rodrigues
authors.forename: S K
authors.initials: SK
authors.lastname: Todi
authors.forename: N
authors.initials: N
authors.lastname: Saini
authors.forename: F E
authors.initials: FE
authors.lastname: Udwadia
authors.forename: A
authors.initials: A
authors.lastname: Karlekar
authors.forename: V
authors.initials: V
authors.lastname: Kothari
authors.forename: S N
authors.initials: SN
authors.lastname: Myatra
authors.forename: M
authors.initials: M
authors.lastname: Chakravarthy
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Dwivedy
authors.forename: N
authors.initials: N
authors.lastname: Sen
authors.forename: S
authors.initials: S
authors.lastname: Sahu
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D007194:India; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies