title: Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium's findings.
abstract: OBJECTIVE
  To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador.
  
  
  METHODS
  A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods.
  
  
  RESULTS
  We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection (CLABSI) rate was 6.5 per 1000 central line (CL)-days, the ventilator-associated pneumonia (VAP) rate was 44.3 per 1000 mechanical ventilator (MV)-days, and the catheter-associated urinary tract infection (CAUTI) rate was 5.7 per 1000 urinary catheter (UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9 (CLABSI) and 5.3 (CAUTI)] and higher than NHSN rates [0.8 (CLABSI) and 1.3 (CAUTI)] - although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC (16.5) and NHSN's rates (1.1), MV DUR was lower in our ICUs. Resistance ofA. baumanniito imipenem and meropenem was 75.0%, and ofPseudomonas aeruginosato ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI.
  
  
  CONCLUSIONS
  DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Estuardo
authors.initials: E
authors.lastname: Salgado Yepez
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Bovera
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: González Flores
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pazmiño
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Francisco
authors.initials: F
authors.lastname: Valencia
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Nelly
authors.initials: N
authors.lastname: Alquinga
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ramirez
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Edgar
authors.initials: E
authors.lastname: Jara
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lascano
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Veronica
authors.initials: V
authors.lastname: Delgado
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Cristian
authors.initials: C
authors.lastname: Cevallos
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Gasdali
authors.initials: G
authors.lastname: Santacruz
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Cristian
authors.initials: C
authors.lastname: Pelaéz
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Celso
authors.initials: C
authors.lastname: Zaruma
authors.affiliation: Estuardo Salgado Yepez, Hugo A González Flores, Francisco Valencia, Vanessa Ramirez, Miguel Lascano, Cristian Cevallos, Cristian Pelaéz, Clínica la Merced, Quito 170401, Ecuador.
authors.forename: Diego
authors.initials: D
authors.lastname: Barahona Pinto
keywords: Antibiotic resistance; Catheter-associated urinary tract infection; Central line-associated bloodstream infections; Developing countries; Healthcare-associated infection; Hospital infection; Intensive care unit; Surveillance; Ventilator-associated pneumonia