title: Multicenter study of device-associated infection rates in hospitals of Mongolia: Findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: BACKGROUND
  To report the results of the International Nosocomial Infection Control Consortium (INICC) multicenter study conducted in Mongolia from September 2013-March 2015.
  
  
  METHODS
  A device-associated health care-associated infection prospective surveillance study in 3 adult intensive care units (ICUs) from 3 hospitals using the U.S. Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) definitions and INICC methods.
  
  
  RESULTS
  We documented 467 ICU patients for 2,133 bed days. The central line-associated bloodstream infection (CLABSI) rate was 19.7 per 1,000 central line days, the ventilator-associated pneumonia (VAP) rate was 43.7 per 1,000 mechanical ventilator days, and the catheter-associated urinary tract infection (CAUTI) rate was 15.7 per 1,000 urinary catheter days; all of the rates are higher than the INICC rates (CLABSI: 4.9; VAP: 16.5; and CAUTI: 5.3) and CDC-NHSN rates (CLABSI: 0.8; VAP: 1.1; and CAUTI: 1.3). Device use ratios were also higher than the CDC-NHSN and INICC ratios, except for the mechanical ventilator device use ratio, which was lower than the INICC ratio. Resistance of Staphylococcus aureus to oxacillin was 100%. Extra length of stay was 15.1 days for patients with CLABSI, 7.8 days for patients with VAP, and 8.2 days for patients with CAUTI. Extra crude mortality in the ICUs was 18.6% for CLABSI, 17.1% for VAP, and 5.1% for CAUTI.
  
  
  CONCLUSIONS
  Device-associated health care-associated infection rates and most device use ratios in our Mongolian hospitals' ICUs are higher than the CDC-NSHN and INICC rates.
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Bat-Erdene
authors.initials: BE
authors.lastname: Ider
authors.affiliation: First State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Otgon
authors.initials: O
authors.lastname: Baatar
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. Electronic address: victor_rosenthal@inicc.org.
authors.forename: Victor Daniel
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: First State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Chuluunchimeg
authors.initials: C
authors.lastname: Khuderchuluun
authors.affiliation: First State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Battsetseg
authors.initials: B
authors.lastname: Baasanjav
authors.affiliation: First State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Chuluunbaatar
authors.initials: C
authors.lastname: Donkhim
authors.affiliation: First State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Byambadorj
authors.initials: B
authors.lastname: Batsuur
authors.affiliation: Second State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Munhzul
authors.initials: M
authors.lastname: Jambiimolom
authors.affiliation: Second State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Suvd-Erdene
authors.initials: SE
authors.lastname: Purevdorj
authors.affiliation: Second State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Uyanga
authors.initials: U
authors.lastname: Tsogtbaatar
authors.affiliation: Second State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Baigalmaa
authors.initials: B
authors.lastname: Sodnomdarjaa
authors.affiliation: Second State Central Hospital, Ulaanbaatar, Mongolia.
authors.forename: Bayasgalan
authors.initials: B
authors.lastname: Gendaram
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Naranpurev
authors.initials: N
authors.lastname: Mendsaikhan
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Tsolmon
authors.initials: T
authors.lastname: Begzjav
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Batsaikhan
authors.initials: B
authors.lastname: Narankhuu
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Bat-Erdene
authors.initials: BE
authors.lastname: Ariungerel
authors.affiliation: Intermed Hospital, Ulaanbaatar, Mongolia.
authors.forename: Bolormaa
authors.initials: B
authors.lastname: Tumendemberel
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina; Universidad Tecnológica Nacional, Facultad Regional San Nicolás and Consejo Nacional de Investigaciones Científicas y Técnicas, San Nicolás, Argentina.
authors.forename: Pablo Wenceslao
authors.initials: PW
authors.lastname: Orellano
mesh_terms: D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D055499:Catheter-Related Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D008986:Mongolia / Q000453:epidemiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology
keywords: Antibiotic resistance; Bed days; Bloodstream infection; Catheter-associated urinary tract infection; Central line–associated bloodstream infections; Health care–associated infection; Network; Nosocomial infection; Urinary tract infection; Ventilator-associated pneumonia