title: Impact of infection control training for interns on PICU-acquired bloodstream infections in a middle-income country.
abstract: BACKGROUND
  The present study aimed to determine the impact of an extended infection control training programme, which was conducted for all interns posted to the Department of Paediatrics, on the incidence of paediatric intensive care unit (PICU)-acquired bloodstream infections (BSIs) in University Malaya Medical Centre, Malaysia.
  
  
  METHODS
  The development of nosocomial BSIs during the baseline period (1 January-31 October 2008) and intervention period (1 November-31 December 2009) was monitored. During the intervention period, all paediatric interns underwent training in hand hygiene and aseptic techniques for accessing vascular catheters.
  
  
  RESULTS
  A total of 25 patients had PICU-acquired BSIs during the baseline period, while 18 patients had PICU-acquired BSIs during the intervention period (i.e. infection rate of 88 per 1,000 and 41 per 1,000 admissions, respectively). The infections were related to central venous catheters (CVCs) in 22 of the 25 patients who had PICU-acquired BSIs during the baseline period and 11 of the 18 patients who had PICU-acquired BSIs during the intervention period. Thus, the incidence rates of catheter-related BSIs were 25.2 per 1,000 CVC-days and 9.3 per 1,000 CVC-days, respectively (p < 0.05). The Paediatric Risk of Standardised Mortality III score was an independent risk factor for PICU-acquired BSIs and the intervention significantly reduced this risk.
  
  
  CONCLUSIONS
  The education of medical interns on infection control, a relatively low-cost intervention, resulted in a substantial reduction in the incidence of PICU-acquired BSIs.
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University Malaya, Malaysia ; Institute Paediatrics, Hospital Kuala Lumpur, Malaysia.
authors.forename: Yun Yun
authors.initials: YY
authors.lastname: Ng
authors.affiliation: School of Clinical Medicine, Australian National University, Canberra Hospital, Australia ; Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Australia.
authors.forename: Mohamed El-Amin
authors.initials: Mel-A
authors.lastname: Abdel-Latif
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University Malaya, Malaysia ; Paediatric Intensive Care Unit, University Malaya Medical Center, Malaysia.
authors.forename: Chin Seng
authors.initials: CS
authors.lastname: Gan
authors.affiliation: Paediatric Intensive Care Unit, University Malaya Medical Center, Malaysia ; Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA, Malaysia.
authors.forename: Anis
authors.initials: A
authors.lastname: Siham
authors.affiliation: Paediatric Intensive Care Unit, University Malaya Medical Center, Malaysia.
authors.forename: Hasimah
authors.initials: H
authors.lastname: Zainol
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University Malaya, Malaysia ; Paediatric Intensive Care Unit, University Malaya Medical Center, Malaysia.
authors.forename: Lucy Chai See
authors.initials: LC
authors.lastname: Lum
mesh_terms: D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002675:Child, Preschool; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D063373:Hand Hygiene; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods; D015278:Intensive Care Units, Pediatric; D007396:Internship and Residency; D008296:Malaysia; D008297:Male; D010372:Pediatrics / Q000193:education; D016016:Proportional Hazards Models
keywords: extended infection control training programme; interns; nosocomial bloodstream infection; paediatric intensive care unit