Device-associated infection rates, bacterial resistance, length of stay, and mortality in Kuwait: International Nosocomial Infection Consortium findings

Haifaa Hassan Al-Mousa 1, Abeer Aly Omar 1, Víctor Daniel Rosenthal 2, Mona Foda Salama 3, Nasser Yehia Aly 4, Mohammad El-Dossoky Noweir 5, Flavie Maria Rebello 3, Dennis Malungcot Narciso 3, Amani Fouad Sayed 5, Anu Kurian 5, Sneha Mary George 5, Amna Mostafa Mohamed 5, Ruby Jose Ramapurath 5, Suga Thomas Varghese 5

Affiliations

01 April 2016

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doi: 10.1016/j.ajic.2015.10.031

Abstract

Background: To report the results of the International Infection Control Consortium (INICC) study conducted in Kuwait from November 2013-March 2015.

Methods: A device-associated health care-acquired infection (DA-HAI) prospective surveillance study in 7 adult, pediatric, and neonatal intensive care units (ICUs) using the U.S. Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) definitions and INICC methods.

Results: We followed 3,732 adult and pediatric patients for 21,611 bed days and 671 neonatal patients for 4,515 bed days. In the medical-surgical ICUs, the central line-associated bloodstream infection (CLABSI) rate was 3.5 per 1,000 central line days, the ventilator-associated pneumonia (VAP) rate was 4.0 per 1,000 mechanical ventilator days, and the catheter-associated urinary tract infection (CAUTI) rate was 3.3 per 1,000 urinary catheter days; all of them were lower than INICC rates (CLABSI: 4.9; VAP: 16.5; and CAUTI: 5.3) and higher than NHSN rates (CLABSI: 0.9; VAP: 1.1; and CAUTI: 1.2). Resistance of Staphylococcus aureus to oxacillin was 100%, resistance of Acinetobacter baumannii to imipenem and meropenem was 77.6%, and resistance of Klebsiella pneumoniae to imipenem and meropenem was 29.4%. Extra length of stay was 27.1 days for CLABSI, 22.2 days for VAP, and 19.2 days for CAUTI in adult and pediatric ICUs. Extra crude mortality was 19.9% for CLABSI, 30.9% for VAP, and 11.1% for CAUTI in adult and pediatric ICUs.

Conclusions: DA-HAI rates in our ICUs are higher than the CDC-NSHN rates and lower than the INICC international rates.

Keywords: Hospital infection; antibiotic resistance; bloodstream infection; catheter-associated urinary tract infection; central line–associated bloodstream infections; health care–associated infection; network; nosocomial infection; urinary tract infection; ventilator-associated pneumonia.

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