Journal
EPIDEMIOLOGY AND INFECTION
Volume 141, Issue 12, Pages 2483-2491Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268813000381
Keywords
Developing countries; device associated infection; hand hygiene; infection control; ventilator-associated pneumonia
Funding
- INICC Country Coordinators and Advisory Board
- Foundation to Fight against Nosocomial Infections
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We report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divided into baseline and intervention periods. During baseline, prospective surveillance of VAP was performed applying the Centers for Disease Control and Prevention/National Healthcare Safety Network definitions and INICC methods. During intervention, our approach in each ICU included a bundle of interventions, education, outcome and process surveillance, and feedback of VAP rates and performance. Crude stratified rates were calculated, and by using random-effects Poisson regression to allow for clustering by ICU, the incidence rate ratio for each time period compared with the 3-month baseline was determined. The VAP rate was 17.43/1000 mechanical ventilator days during baseline, and 10.81 for intervention, showing a 38% VAP rate reduction (relative risk 0.62, 95% confidence interval 0.5-0.78, P=0.0001).
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