International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012.
BACKGROUND
Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012.


METHODS
A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods.


RESULTS
We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI).


CONCLUSIONS
DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.
Hakan
H
Leblebicioglu
Nurettin
N
Erben
Victor Daniel
VD
Rosenthal
Begüm
B
Atasay
Ayse
A
Erbay
Serhat
S
Unal
Gunes
G
Senol
Ayse
A
Willke
Asu
A
Özgültekin
Nilgün
N
Altin
Mehmet
M
Bakir
Oral
O
Oncul
Gülden
G
Ersöz
Davut
D
Ozdemir
Ata Nevzat
AN
Yalcin
Halil
H
Özdemir
Dinçer
D
Yıldızdaş
Iftihar
I
Koksal
Canan
C
Aygun
Fatma
F
Sirmatel
Alper
A
Sener
Nazan
N
Tuna
Özay Arikan
ÖA
Akan
Huseyin
H
Turgut
A Pekcan
AP
Demiroz
Tanil
T
Kendirli
Emine
E
Alp
Cengiz
C
Uzun
Sercan
S
Ulusoy
Dilek
D
Arman
D000293:Adolescent; D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology*; D004864:Equipment and Supplies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D014421:Turkey / Q000453:epidemiology