Evaluating the outcome of a bundle with 11 components and the INICC multidimensional approach in decreasing rates of central line-associated bloodstream infections across nine Asian countries

Rosenthal VD 1 , Yin R 2 , Myatra SN 3 , Divatia JV 3 , Biswas SK 3 , Shrivastava AM 3 Show all authors , Perez V 4 , Wang QY 5 , Todi SK 6 , Tang SF 7 , Tai CW 7 , Lee PC 8 , Sengupta D 9 , Sarma S 10 , Sandhu K 9 , Rodrigues C 11 , Nag B 12 , Mohd-Basri MN 13 , Mehta Y 14 , Kharbanda M 12 , Kansal S 15 , Jain AC 15 , Davaadagva N 16 , Chuah SL 5 , Low MSY 5 , Gan CS 5 , Bt Madzlan Kushairi M 5 , Bhattacharyya M 6 , Bhakta A 6 , Begzjav T 16 , Bat-Erdene B 16 , Bali RK 15 , Badyal B 9 , Arora A 9 , Arjun R 15 , Tao L 17 , Jin Z 2 , Chawla R 15

Affiliations 

  • 1 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
  • 2 University of Miami Miller School of Medicine, Miami, FL, USA
  • 3 Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
  • 4 Department of Biological Sciences, Florida International University, Miami, FL, USA
  • 5 Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 6 AMRI Hospitals, Kolkata, West Bengal, India
  • 7 Universiti Kebangsaan Malaysia Fakulti Perubatan, Cheras, Federal Territory of Kuala Lumpur, Malaysia
  • 8 Paediatrics, Universiti Kebangsaan Malaysia Fakulti Perubatan, Cheras, Federal Territory of Kuala Lumpur, Malaysia
  • 9 Max Super Speciality Hospital Saket, New Delhi, Delhi, India
  • 10 Clinical Microbiology and Infection Prevention and Control, Medanta The Medicity, Gurgaon, Haryana, India
  • 11 PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  • 12 Desun Hospital, Kolkata, West Bengal, India
  • 13 International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 14 Medanta The Medicity, Gurgaon, Haryana, India
  • 15 Indraprastha Apollo Hospital, New Delhi, Delhi, India
  • 16 Intermed Hospital, Ulaanbaatar, Mongolia
  • 17 Zhongshan Hospital Fudan University, Shanghai, China
J Vasc Access, 2024 Mar 27.
PMID: 38539085 DOI: 10.1177/11297298241242163

Abstract

BACKGROUND: Central line-associated bloodstream infection (CLABSI) rates in intensive care units (ICUs) across Latin America exceed those in high-income countries significantly.

METHODS: We implemented the INICC multidimensional approach, incorporating an 11-component bundle, in 122 ICUs spanning nine Asian countries. We computed the CLABSI rate using the CDC/NSHN definition and criteria. The CLABSI rate per 1000 CL-days was calculated at baseline and throughout different phases of the intervention, including the 2nd month, 3rd month, 4-16 month, and 17-29 month periods. A two-sample t-test was employed to compare baseline CLABSI rates with intervention rates. Additionally, we utilized a generalized linear mixed model with a Poisson distribution to analyze the association between exposure and outcome.

RESULTS: A total of 124,946 patients were hospitalized over 717,270 patient-days, with 238,595 central line (CL)-days recorded. The rates of CLABSI per 1000 CL-days significantly decreased from 16.64 during the baseline period to 6.51 in the 2nd month (RR = 0.39; 95% CI = 0.36-0.42; p 

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

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