International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2013-2018, Adult and Pediatric Units, Device-associated Module

Victor Daniel Rosenthal 1, Wieslawa Duszynska 2, Bat-Erdene Ider 3, Vaidotas Gurskis 4, Majeda A Al-Ruzzieh 5, Sheila Nainan Myatra 6, Debkishore Gupta 7, Souad Belkebir 8, Namita Upadhyay 9, Farid Zand 10, Subhash Kumar Todi 11, Mohit Kharbanda 12, Pravin K Nair 13, Sanghamitra Mishra 14, Gustavo Chaparro 15, Yatin Mehta 16, Dolatsinh Zala 17, Jaroslaw Janc 18, Guadalupe Aguirre-Avalos 19, Daisy Aguilar-De-Morós 20, Blanca Estela Hernandez-Chena 21, Emrah Gün 22, Nefise Oztoprak-Cuvalci 23, Dincer Yildizdas 24, Mona Moheyeldin Abdelhalim 25, Suna Secil Ozturk-Deniz 26, Chin Seng Gan 27, Nguyen Viet Hung 28, Hala Joudi 29, Abeer Aly Omar 30, Achilleas Gikas 31, Amani Ali El-Kholy 32, Amina Barkat 33, Anjeela Koirala 34, Antonio Cerero-Gudiño 35, Asma Bouziri 36, Katherine Gomez-Nieto 37, Dale Fisher 38, Eduardo A Medeiros 39, Estuardo Salgado-Yepez 40, Florin Horhat 41, Hala Mounir Moustafa Agha 25, Julio César Vimercati 42, Victoria Villanueva 43, Kushlani Jayatilleke 44, Le Thi Thu Nguyet 45, Lul Raka 46, María Guadalupe Miranda-Novales 47, Michael Mihailov Petrov 48, Anucha Apisarnthanarak 49, Nadia Tayyab 50, Naheed Elahi 51, Nepomuceno Mejia 52, Rayo Morfin-Otero 53, Safa Al-Khawaja 54, Tanja Anguseva 55, Umesh Gupta 56, Vladislav A Belskii 57, Wan Rahiza Wan Mat 58, Edwin Giovanny Chapeta-Parada 59, Humberto Guanche-Garcell 60, Nayide Barahona-Guzmán 61, Anju Mathew 62, Kavita Raja 63, Saroj Kumar Pattnaik 64, Nirav Pandya 65, Aruna Ananda Poojary 66, Rajesh Chawla 67, Tahsine Mahfouz 68, Souha S Kanj 69, Vesna Mioljevic 70, Sona Hlinkova 71, Mariana Mrazova 72, Hail M Al-Abdely 73, Ertugrul Guclu 74, Asu Ozgultekin 75, Volkan Baytas 76, Recep Tekin 77, Ata Nevzat Yalçın 78, Nurettin Erben 79

Affiliations

10 January 2021

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doi: 10.1016/j.ajic.2021.04.077

Abstract

Background: We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific.

Methods: Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied.

Results: We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases.

Conclusions: DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them.

Keywords: Bacterial resistance; Device-associated infection; Health care-associated infection; Hospital infection; Limited resources countries; Nosocomial infection.

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