title: Trends in the incidence rate of device-associated infections in intensive care units after the establishment of the Korean Nosocomial Infections Surveillance System.
abstract: BACKGROUND
  The effectiveness of continuous nationwide surveillance on healthcare-associated infections should be investigated in each country.
  
  
  OBJECTIVE
  To assess the rate of device-associated infections (DAIs) in intensive care units (ICUs) since the establishment of the Korean Nosocomial Infections Surveillance System (KONIS).
  
  
  METHODS
  Nationwide data were obtained on the incidence rate of DAI in ICUs reported to KONIS by all participating hospitals. The three major DAIs were studied: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CABSI), and catheter-associated urinary tract infection (CAUTI). The pooled and year-wise incidence rates (cases per 1000 device-days) of these DAIs were determined for the period 2006 and 2012. In addition, data from institutions that had participated in KONIS for at least three consecutive years were analysed separately.
  
  
  RESULTS
  The number of ICUs participating in KONIS gradually increased from 76 in 2006 to 162 in 2012. Between 2006 and 2012, the incidence rate per 1000 device-days for VAP decreased significantly from 3.48 to 1.64 (F = 11, P < 0.01), for CAUTI the rate decreased non-significantly from 1.85 to 1.26 (F = 2.02, P = 0.07), and for CABSI the rate also decreased non-significantly from 3.4 to 2.57 (F = 1.73, P = 0.12). In the 132 ICUs that had participated in KONIS for at least three consecutive years, the VAP rate significantly decreased from the first year to third year (F = 20.57, P < 0.01), but the rates of CAUTI (F = 1.06, P = 0.35) and CABSI (F = 1.39, P = 0.25) did not change significantly.
  
  
  CONCLUSIONS
  The decreased incidence rate of VAP in ICUs in Korea might be associated with the continuous prospective surveillance provided by KONIS.
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: seran@yuhs.ac.
authors.forename: J Y
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea.
authors.forename: Y G
authors.initials: YG
authors.lastname: Kwak
authors.affiliation: Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, South Korea.
authors.forename: H
authors.initials: H
authors.lastname: Yoo
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: S-O
authors.initials: SO
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: H B
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Infection Prevention and Control, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
authors.forename: Y K
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Infection Control Office, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: S R
authors.initials: SR
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, South Korea.
authors.forename: T H
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Kwandong University College of Medicine, Gangneung, South Korea.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Infection Control, Kyunghee University Hospital, Seoul, South Korea.
authors.forename: H K
authors.initials: HK
authors.lastname: Chun
authors.affiliation: Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, South Korea.
authors.forename: J-S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Eulji University School of Medicine, Eulji General Hospital, Seoul, South Korea.
authors.forename: B W
authors.initials: BW
authors.lastname: Eun
authors.affiliation: Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea.
authors.forename: D W
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Division of Infectious Disease Control, Korea Centers for Disease Control & Prevention, Osong, South Korea.
authors.forename: H-S
authors.initials: HS
authors.lastname: Koo
authors.affiliation: Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, South Korea.
authors.forename: G-R
authors.initials: GR
authors.lastname: Bae
authors.affiliation: Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: K
authors.initials: K
authors.lastname: Lee
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D062665:Epidemiological Monitoring; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology
keywords: Device-associated infections; Healthcare-associated infection; Surveillance