Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings
Víctor Rosenthal, Ider Bat-Erdene, Debkishore Gupta, Souad Belkebir, Prasad Rajhans, Farid Zand, Sheila Nainan Myatra, Majeda Afeef, V. Tanzi, S. Muralidharan, Hail M. Al-Abdely, Amani El‐Kholy, Safa Alkhawaja, Ali Pekcan Demiröz, Yatin Mehta, Vineya Rai, Nguyễn Việt Hưng, Amani F. Sayed, Estuardo Salgado-Yepez, Naheed Elahi, María del Rayo Morfín-Otero, Montri Luxsuwong, Braulio Matias De-Carvalho, Audrey Rose D. Tapang, V. Velinova, Ana Marcela Quesada-Mora, Tanja Anguseva, Aamer Ikram, Daisy Aguilar-de-Moros, Wiesława Duszyńska, Nepomuceno Mejía, Florin George Horhat, Vladislav Belskiy, Vesna Mioljević, Gabriela Di-Silvestre, Katarina Furova, May Osman Gamar-Elanbya, Umesh Gupta, Khalid Abidi, Lul Raka, Xiuqin Guo, Kushlani Jayatilleke, Najla Ben-Jaballah, Harrison Ronald Sandoval-Castillo, Andrew Trotter, Sandra Valderrama, Hakan Leblebicioğlu, Humberto Guanche Garcell, Miriam de Lourdes-Dueñas
Abstract
BACKGROUND: Short-term peripheral venous catheter-related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available. METHODS: Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS: We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%). CONCLUSIONS: PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.