title: Device-associated infection rates, bacterial resistance, length of stay, and mortality in Kuwait: International Nosocomial Infection Consortium findings.
abstract: BACKGROUND
  To report the results of the International Infection Control Consortium (INICC) study conducted in Kuwait from November 2013-March 2015.
  
  
  METHODS
  A device-associated health care-acquired infection (DA-HAI) prospective surveillance study in 7 adult, pediatric, and neonatal intensive care units (ICUs) using the U.S. Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) definitions and INICC methods.
  
  
  RESULTS
  We followed 3,732 adult and pediatric patients for 21,611 bed days and 671 neonatal patients for 4,515 bed days. In the medical-surgical ICUs, the central line-associated bloodstream infection (CLABSI) rate was 3.5 per 1,000 central line days, the ventilator-associated pneumonia (VAP) rate was 4.0 per 1,000 mechanical ventilator days, and the catheter-associated urinary tract infection (CAUTI) rate was 3.3 per 1,000 urinary catheter days; all of them were lower than INICC rates (CLABSI: 4.9; VAP: 16.5; and CAUTI: 5.3) and higher than NHSN rates (CLABSI: 0.9; VAP: 1.1; and CAUTI: 1.2). Resistance of Staphylococcus aureus to oxacillin was 100%, resistance of Acinetobacter baumannii to imipenem and meropenem was 77.6%, and resistance of Klebsiella pneumoniae to imipenem and meropenem was 29.4%. Extra length of stay was 27.1 days for CLABSI, 22.2 days for VAP, and 19.2 days for CAUTI in adult and pediatric ICUs. Extra crude mortality was 19.9% for CLABSI, 30.9% for VAP, and 11.1% for CAUTI in adult and pediatric ICUs.
  
  
  CONCLUSIONS
  DA-HAI rates in our ICUs are higher than the CDC-NSHN rates and lower than the INICC international rates.
authors.affiliation: Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Haifaa Hassan
authors.initials: HH
authors.lastname: Al-Mousa
authors.affiliation: Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Abeer Aly
authors.initials: AA
authors.lastname: Omar
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. Electronic address: victor_rosenthal@inicc.org.
authors.forename: Víctor Daniel
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: Mubarak Al Kabir Hospital, Kuwait City, Kuwait.
authors.forename: Mona Foda
authors.initials: MF
authors.lastname: Salama
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait; Department of Tropical Medicine and Hygiene, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
authors.forename: Nasser Yehia
authors.initials: NY
authors.lastname: Aly
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Mohammad
authors.initials: M
authors.lastname: El-Dossoky Noweir
authors.affiliation: Mubarak Al Kabir Hospital, Kuwait City, Kuwait.
authors.forename: Flavie Maria
authors.initials: FM
authors.lastname: Rebello
authors.affiliation: Mubarak Al Kabir Hospital, Kuwait City, Kuwait.
authors.forename: Dennis Malungcot
authors.initials: DM
authors.lastname: Narciso
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Amani Fouad
authors.initials: AF
authors.lastname: Sayed
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Anu
authors.initials: A
authors.lastname: Kurian
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Sneha Mary
authors.initials: SM
authors.lastname: George
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Amna Mostafa
authors.initials: AM
authors.lastname: Mohamed
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Ruby Jose
authors.initials: RJ
authors.lastname: Ramapurath
authors.affiliation: Farwaniya Hospital, Kuwait City, Kuwait.
authors.forename: Suga Thomas
authors.initials: ST
authors.lastname: Varghese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000401:mortality; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007730:Kuwait / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies; D016019:Survival Analysis
keywords: Hospital infection; antibiotic resistance; 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