International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009

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• 作者：Victor D. Rosenthal ; MD ; MSc ; CIC^a ; ^{victor_rosenthal@inicc.org} ; Hu Bijie ; MD^b ; Dennis G. Maki ; MD^c ; Yatin Mehta ; MD^d ; Anucha Apisarnthanarak ; MD^e ; Eduardo A. Medeiros ; MD^f ; Hakan Leblebicioglu ; MD^g ; Dale Fisher ; MD^h ; Carlos Á ; lvarez-Moreno ; MDⁱ ; Ilham Abu Khader ; MD^j ; Marisela Del Rocí ; o Gonzá ; lez Martí ; nez ; MD^k ; Luis E. Cuellar ; MD^l ; Josephine Anne Navoa-Ng ; MD^m ; Ré ; douane Abouqal ; MDⁿ ; Humberto Guanche Garcell ; MD^o ; Zan Mitrev ; MD^p ; Marí ; a Catalina Pirez Garcí ; a ; MD^q ; Asma Hamdi ; MD^r ; Lourdes Dueñ ; as ; MD^s ; Elsie Cancel ; MD^t ; Vaidotas Gurskis ; MD^u ; Ossama Rasslan ; MD^v ; Altaf Ahmed ; MD^w ; Souha S. Kanj ; MD^x ; Olber Chavarrí ; a Ugalde ; RN^y ; Trudell Mapp ; RN^z ; Lul Raka ; MD^aa ; Cheong Yuet Meng ; MD^bb ; Le Thi Anh Thu ; MD^cc ; Sameeh Ghazal ; MD^dd ; Achilleas Gikas ; MD^ee ; Leonardo Pazmiñ ; o Narvá ; ez ; MD^ff ; Nepomuceno Mejí ; a ; MD^gg ; Nassya Hadjieva ; MD^hh ; May Osman Gamar Elanbya ; MDⁱⁱ ; Marí ; a Eugenia Guzmá ; n Siritt ; MD^jj ; Kushlani Jayatilleke ; MD^kk ; INICC members
• 关键词：Network ; Hospital infection ; Nosocomial infection ; Health care-associated infection ; Device-associated infection ; Ventilator-associated pneumonia ; Catheter-associated urinary tract infection ; Central line-associated bloodstream infection ; Bloodstream infe
• 刊名：American Journal of Infection Control
• 出版年：2012
• 期刊代码：9_01966553
• 类别：med
• 出版时间：June, 2012
• 卷：40
• 期：5
• 页码：396-407
• 文件大小：202 K

摘要

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium鈥檚 ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries鈥?ICUs was remarkably similar to that reported in US ICUs in the CDC鈥檚 NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2%vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3%vs 27.1%), Escherichia coli isolates to ceftazidime (66.7%vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4%vs 56.8%), were also higher in the consortium鈥檚 ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3%(for catheter-associated urinary tract infection) to 15.2%(for ventilator-associated pneumonia).