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Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14 developing countries of four continents: Findings of the International Nosocomial Infection Control Consortium

Show simple item record Rosenthal V.D. Rodrigues C. Alvarez-Moreno C. Madani N. Mitrev Z. Ye G. Salomao R. Ulger F. Guanche-Garcell H. Kanj S.S. Cuellar L.E. Higuera F. Mapp T. Fernandez-Hidalgo R.
dc.contributor.editor Dec-2012 2017-10-05T15:39:55Z 2017-10-05T15:39:55Z 2012
dc.identifier 10.1097/CCM.0b013e3182657916
dc.identifier.issn 00903493
dc.description.abstract ObjectiveS:: The aim of this study was to analyze the effect of the International Nosocomial Infection Control Consortium's multidimensional approach on the reduction of ventilator-associated pneumonia in patients hospitalized in intensive care units. DESIGN:: A prospective active surveillance before-after study. The study was divided into two phases. During phase 1, the infection control team at each intensive care unit conducted active prospective surveillance of ventilator-associated pneumonia by applying the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the methodology of International Nosocomial Infection Control Consortium. During phase 2, the multidimensional approach for ventilator-associated pneumonia was implemented at each intensive care unit, in addition to the active surveillance. SETTING:: Forty-four adult intensive care units in 38 hospitals, members of the International Nosocomial Infection Control Consortium, from 31 cities of the following 14 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, and Turkey. PATIENTS:: A total of 55,507 adult patients admitted to 44 intensive care units in 38 hospitals. INTERVENTIONS:: The International Nosocomial Infection Control Consortium ventilator-associated pneumonia multidimensional approach included the following measures: 1) bundle of infection-control interventions; 2) education; 3) outcome surveillance; 4) process surveillance; 5) feedback of ventilator-associated pneumonia rates; and 6) performance feedback of infection-control practices. MEASUREMENTS:: The ventilator-associated pneumonia rates obtained in phase 1 were compared with the rates obtained in phase 2. We performed a time-series analysis to analyze the impact of our intervention. MAIN RESULT:: During phase 1, we recorded 10,292 mechanical ventilator days, and during phase 2, with the implementation of the multidimensional approach, we recorded 127,374 mechanical ventilator days. The rate of ventilator-associated pneumonia was 22.0 per 1,000 mechanical ventilator days during phase 1, and 17.2 per 1,000 mechanical ventilator days during phase 2.The adjusted model of linear trend shows a 55.83percent reduction in the rate of ventilator-associated pneumonia at the end of the study period; that is, the ventilator-associated pneumonia rate was 55.83percent lower than it was at the beginning of the study. CONCLUSION:: The implementation the International Nosocomial Infection Control Consortium multidimensional approach for ventilator-associated pneumonia was associated with a significant reduction in the ventilator-associated pneumonia rate in the adult intensive care units setting of developing countries. © 2012 by the Society of Critical Care Medicine and Lippincott Williams and Wilkins.
dc.format.extent Pages: (3121-3128)
dc.language English
dc.publisher PHILADELPHIA
dc.relation.ispartof Publication Name: Critical Care Medicine; Publication Year: 2012; Volume: 40; no. 12; Pages: (3121-3128);
dc.source Scopus
dc.title Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14 developing countries of four continents: Findings of the International Nosocomial Infection Control Consortium
dc.type Article
dc.contributor.affiliation Rosenthal, V.D., Infection Control Department (VDR), International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
dc.contributor.affiliation Rodrigues, C., Infection Control Department, PD Hinduja National Hospital, Medical Research Centre, Mumbai, India
dc.contributor.affiliation Álvarez-Moreno, C., Infection Control Department, Hospital Universitario San Ignacio, Universidad Pontificia Javeriana, Bogotá, Colombia
dc.contributor.affiliation Madani, N., Infection Control Department, Ibn Sina-Medical ICU, Rabat, Morocco
dc.contributor.affiliation Mitrev, Z., Infection Control Department, Filip II Special Hospital for Surgery, Skopje, Macedonia
dc.contributor.affiliation Ye, G., Infection Control Department, Yangpu Hospital, Shanghai, China
dc.contributor.affiliation Salomao, R., Infection Control Department, Hospital Santa Marcelina, São Paulo, Brazil
dc.contributor.affiliation Ulger, F., Infection Control Department, Ondokuz Mayis University Medical School, Samsun, Turkey
dc.contributor.affiliation Guanche-Garcell, H., Infection Control Department, Hospital Docente Clinico Quirurgico Joaquin Albarran Dominguez, Havana, Cuba
dc.contributor.affiliation Kanj, S.S., Infection Control Department, American University, Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Cuéllar, L.E., Infection Control Department, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru
dc.contributor.affiliation Higuera, F., Infection Control Department, Hospital General de México, Mexico City, Mexico
dc.contributor.affiliation Mapp, T., Infection Control Department, Clínica Hospital San Fernando, Panama City, Panama
dc.contributor.affiliation Fernández-Hidalgo, R., Infection Control Department, Hospital Clínica Bíblica, San José, Costa Rica
dc.contributor.authorAddress Rosenthal, V.D.; Infection Control Department (VDR), International Nosocomial Infection Control Consortium, Buenos Aires, Argentina; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Infectious Diseases;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Infectious Diseases
dc.contributor.faculty Faculty of Medicine
dc.contributor.authorInitials Rosenthal, VD
dc.contributor.authorInitials Rodrigues, C
dc.contributor.authorInitials Alvarez-Moreno, C
dc.contributor.authorInitials Madani, N
dc.contributor.authorInitials Mitrev, Z
dc.contributor.authorInitials Ye, GX
dc.contributor.authorInitials Salomao, R
dc.contributor.authorInitials Ulger, F
dc.contributor.authorInitials Guanche-Garcell, H
dc.contributor.authorInitials Kanj, SS
dc.contributor.authorInitials Cuellar, LE
dc.contributor.authorInitials Higuera, F
dc.contributor.authorInitials Mapp, T
dc.contributor.authorInitials Fernandez-Hidalgo, R
dc.contributor.authorReprintAddress Rosenthal, VD (reprint author), Int Nosocomial Infect Control Consortium, Infect Control Dept, Buenos Aires, DF, Argentina.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 22
dc.description.citedTotWOSCount 28
dc.description.citedWOSCount 27
dc.format.extentCount 8
dc.identifier.coden CCMDC
dc.identifier.pubmedID 22975890
dc.identifier.scopusID 84870242875
dc.publisher.address 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
dc.relation.ispartOfISOAbbr Crit. Care Med.
dc.relation.ispartOfIssue 12
dc.relation.ispartofPubTitle Critical Care Medicine
dc.relation.ispartofPubTitleAbbr Crit. Care Med.
dc.relation.ispartOfVolume 40
dc.source.ID WOS:000311427100001
dc.type.publication Journal
dc.subject.otherAuthKeyword developing countries
dc.subject.otherAuthKeyword intensive care unit
dc.subject.otherAuthKeyword international multidimensional approach
dc.subject.otherAuthKeyword International Nosocomial Infection Control Consortium
dc.subject.otherAuthKeyword ventilator-associated pneumonia
dc.subject.otherChemCAS ceftriaxone, 73384-59-5, 74578-69-1
dc.subject.otherChemCAS ciprofloxacin, 85721-33-1
dc.subject.otherChemCAS imipenem, 64221-86-9
dc.subject.otherChemCAS meticillin, 132-92-3, 38882-79-0, 61-32-5
dc.subject.otherIndex antibiotic agent
dc.subject.otherIndex ceftriaxone
dc.subject.otherIndex ciprofloxacin
dc.subject.otherIndex imipenem
dc.subject.otherIndex meticillin
dc.subject.otherIndex piperacillin plus tazobactam
dc.subject.otherIndex quinolone derivative
dc.subject.otherIndex Acinetobacter
dc.subject.otherIndex adult
dc.subject.otherIndex antibiotic resistance
dc.subject.otherIndex article
dc.subject.otherIndex artificial ventilation
dc.subject.otherIndex developing country
dc.subject.otherIndex disease severity
dc.subject.otherIndex female
dc.subject.otherIndex hospital patient
dc.subject.otherIndex hospital personnel
dc.subject.otherIndex human
dc.subject.otherIndex infection control
dc.subject.otherIndex intensive care unit
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex priority journal
dc.subject.otherIndex prospective study
dc.subject.otherIndex risk factor
dc.subject.otherIndex Staphylococcus aureus
dc.subject.otherIndex ventilator associated pneumonia
dc.subject.otherIndex Adult
dc.subject.otherIndex Aged
dc.subject.otherIndex Cohort Studies
dc.subject.otherIndex Cross Infection
dc.subject.otherIndex Developing Countries
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Infection Control
dc.subject.otherIndex Intensive Care Units
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Pneumonia, Ventilator-Associated
dc.subject.otherIndex Population Surveillance
dc.subject.otherIndex Program Evaluation
dc.subject.otherIndex Prospective Studies
dc.subject.otherKeywordPlus RANDOMIZED CONTROLLED-TRIAL
dc.subject.otherKeywordPlus BLOOD-STREAM INFECTIONS
dc.subject.otherKeywordPlus LENGTH-OF-STAY
dc.subject.otherKeywordPlus PERFORMANCE FEEDBACK
dc.subject.otherKeywordPlus HAND HYGIENE
dc.subject.otherKeywordPlus MECHANICAL VENTILATION
dc.subject.otherKeywordPlus ARGENTINEAN HOSPITALS
dc.subject.otherKeywordPlus CONTROL PROGRAM
dc.subject.otherKeywordPlus RATES
dc.subject.otherKeywordPlus INICC
dc.subject.otherWOS Critical Care Medicine

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