NDLI: Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Content Provider	Springer Nature : BioMed Central
Author	Leblebicioglu, Hakan Öztürk, Recep Rosenthal, Victor Daniel Akan, Özay Arıkan Sirmatel, Fatma Ozdemir, Davut Uzun, Cengiz Turgut, Huseyin Ersoz, Gulden Koksal, Iftíhar Özgültekin, Asu Esen, Saban Ulger, Fatma Dilek, Ahmet Yilmaz, Hava Dikmen, Yalim Aygún, Gökhan Tulunay, Melek Oral, Mehmet Ünal, Necmettin Cengiz, Mustafa Yilmaz, Leyla Geyik, Mehmet Faruk Şahin, Ahmet Erdogan, Selvi Sacar, Suzan Sungurtekin, Hülya Uğurcan, Doğaç Kaya, Ali Kuyucu, Necdet Yýlmaz, Gürdal Kaya, Selçuk Ulusoy, Hülya İnan, Asuman
Abstract	Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB. Conclusions The implementation of multidimensional infection control approach was associated with a significant reduction in the CLAB rates in adult ICUs of Turkey, and thus should be widely implemented.
Related Links	https://ann-clinmicrob.biomedcentral.com/counter/pdf/10.1186/1476-0711-12-10.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14760711
DOI	10.1186/1476-0711-12-10
Journal	Annals of Clinical Microbiology and Antimicrobials
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2013-05-04
Access Restriction	Open
Subject Keyword	Medical Microbiology Infectious Diseases Drug Resistance Microbial Genetics and Genomics Biochemistry Parasitology Catheter related infections Central line-associated bloodstream infection Device-associated infections Healthcare-associated infections Bundle International nosocomial infection control consortium Multidimensional approach Hand hygiene Developing countries Limited-resource countries
Content Type	Text
Resource Type	Article
Subject	Microbiology (medical) Infectious Diseases
Journal Impact Factor	4.6/2023
5-Year Journal Impact Factor	5.3/2023

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