Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe

Rosenthal VD 1 , Jin Z 2 , Yin R 2 , Sahu S 3 , Rajhans P 4 , Kharbanda M 5 Show all authors , Nair PK 6 , Mishra SB 7 , Chawla R 8 , Arjun R 9 , Sandhu K 10 , Rodrigues C 11 , Dongol R 12 , Myatra SN 13 , Mohd-Basri MN 14 , Chian-Wern T 15 , Bhakta A 16 , Bat-Erdene I 17 , Acharya SP 18 , Alvarez GA 19 , Moreno LAA 20 , Gomez K 21 , da Jimenez-Alvarez LF 22 , Henao-Rodas CM 23 , Valderrama-Beltran SL 24 , Zuniga-Chavarria MA 25 , Aguirre-Avalos G 26 , Hernandez-Chena BE 27 , Sassoe-Gonzalez A 28 , Aleman-Bocanegra MC 29 , Villegas-Mota MI 30 , De Moros DA 31 , Castaneda-Sabogal A 32 , Carreazo NY 33 , Alkhawaja S 34 , Agha HM 35 , El-Kholy A 36 , Abdellatif-Daboor M 37 , Dursun O 38 , Okulu E 39 , Havan M 40 , Yildizdas D 41 , Deniz SSO 42 , Guclu E 43 , Hlinkova S 44 , Ikram A 45 , Tao L 46 , Omar AA 47 , Elahi N 48 , Memish ZA 49 , Petrov MM 50 , Raka L 51 , Janc J 52 , Horhat-Florin G 53 , Medeiros EA 54 , Salgado E 55 , Dueñas L 56 , Coloma M 2 , Perez V 57 , Brown EC 2

Affiliations 

  • 1 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA. Electronic address: vdr21@miami.edu
  • 2 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
  • 3 Apollo Hospital Bhubaneswar, Bhubaneswar, India
  • 4 Deenanath Mangeshkar Hospital and Research Center Erandwane Pune, Pune, India
  • 5 Desun Hospital & Heart Institute Kolkata, Kolkata, India
  • 6 Holy Spirit Hospital, Mumbai, India
  • 7 IMS And SUM Hospital, Bhubaneswar, India
  • 8 Indraprastha Apollo Hospital Delhi, New Delhi, India
  • 9 Kerala Institute of Med Sciences Health, Trivandrum, India
  • 10 Max Super Speciality Hospital Saket Delhi, New Delhi, India
  • 11 Pd Hinduja National Hospital and Medical Research Centre, Mumbai, India
  • 12 Grande International Hospital, Kathamandu, Nepal
  • 13 Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
  • 14 International Islamic University Malaysia, Department of Anesthesia and Critical Care, Kuantan, Malaysia
  • 15 Universiti Kebangsaan Malaysia Specialist Children's Hospital, Kuala Lumpur, Malaysia
  • 16 University Malaya Medical Centre, Department of Pediatric Intensive Care, Kuala Lumpur, Malaysia
  • 17 Intermed Hospital, Ulaanbaatar, Mongolia
  • 18 Grande International Hospital, Kathmandu, Nepal
  • 19 Instituto Central de Medicina, La Plata, Provincia de Buenos Aires, Argentina
  • 20 Clinica Infantil Santa María del Lago, Bogota, Colombia
  • 21 Clinica Sebastian de Belalcazar, Cali, Colombia
  • 22 Clinica Universitaria Colombia, Bogota, Colombia
  • 23 Fundacion Hospital San Jose De Buga, Guadalajara De Buga, Colombia
  • 24 Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia
  • 25 Hospital Clinica Biblica, San Jose De Costa Rica, Costa Rica
  • 26 Hospital Civil De Guadalajara Fray Antonio Alcalde Terapia Intensiva, Guadalajara, Mexico
  • 27 Hospital General Regional 6 De Ciudad Madero, Madero, Mexico
  • 28 Hospital Regional De Alta Especialidad De Ixtapaluca, Ixtapaluca, Mexico
  • 29 Hospital San José De Monterrey Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  • 30 Instituto Nacional De Perinatologia Unidad De Cuidados Intensivos Neonatales, Mexico City, Mexico
  • 31 Hospital Del Nino Dr Jose Renan Esquivel De Panama, Panama, Panama
  • 32 Hospital Victor Lazarte Echegaray, Trujillo, Peru
  • 33 Universidad Peruana de Ciencias Aplicadas, Hospital de Emergencias Pediatricas, Lima, Peru
  • 34 Salmaniya Medical Complex, Manama, Bahrain
  • 35 Cairo University Specialized Pediatric Hospital Cardio Thoracic Icu, Cairo, Egypt
  • 36 Dar Alfouad Hospital, 6th Of October City, Egypt
  • 37 King Hussein Cancer Center, Amman, Jordan
  • 38 Akdeniz University Medical School, Antalya, Turkey
  • 39 Ankara University Faculty of Medicine Childrens Hospital NICU, Ankara, Turkey
  • 40 Ankara University Faculty of Medicine, Ankara, Turkey
  • 41 Balcali Hospital Pediatric Intensive Care Unit, Adana, Turkey
  • 42 Pamukkale University Hospital, Denizli, Turkey
  • 43 Sakarya University Training and Research Hospital, Sakarya, Turkey
  • 44 Catholic University in Ruzomberok Faculty of Health Central Military Hospital Snp Ruzomberok, Ruzomberok, Slovakia
  • 45 Armed Forces Institute of Urology, Rawalpindi, Pakistan
  • 46 Zhongshan Hospital, Fudan University, Shanghai, China
  • 47 Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait
  • 48 Dubai Hospital, United Arab Emirates
  • 49 King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
  • 50 Department of Microbiology, Faculty of Pharmacy, Medical University of Plovdiv, Bulgaria
  • 51 National Institute for Public Health, Prishtina, Kosovo
  • 52 Department of Anesthesiology and Intensive Therapy, 4th Clinical Military Hospital with Polyclinic, Wroclaw, Poland
  • 53 University of Medicine and Pharmacy Victor Babes Timisoara Emergency Clinical County Hospital Romania, Timisoara, Romania
  • 54 Hospital Sao Paulo, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • 55 Hospital Marie Curie, Ecuador
  • 56 Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
  • 57 Department of Biological Sciences, Florida International University, Miami, Fl, USA
J Crit Care, 2024 Apr;80:154500.
PMID: 38128216 DOI: 10.1016/j.jcrc.2023.154500

Abstract

BACKGROUND: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal.

METHODS: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods.

RESULTS: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58-0.65; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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