Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East

Rosenthal, Victor D. and Yin, Ruijie and Jin, Zhilin and Perez, Valentina and Kis, Matthew A. and Abdulaziz-Alkhawaja, Safaa and Valderrama-Beltran, Sandra L. and Gomez, Katherine and Rodas, Claudia M.H. and El-Sisi, Amal and Sahu, Suneeta and Kharbanda, Mohit and Rodrigues, Camilla and Myatra, Sheila N. and Chawla, Rajesh and Sandhu, Kavita and Mehta, Yatin and Rajhans, Prasad and Arjun, Rajalakshmi and Tai, Chian-Wern and Bhakta, Arpita and Mat Nor, Mohd Basri (2024) Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East. American Journal of Infection Control, 52 (8). pp. 906-914. ISSN 0196-6553

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Abstract

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden. Methods: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries. The dependent variable was CAUTI per 1,000 UC days, assessed at baseline and throughout the intervention, in the second month, third month, 4 to 15 months, 16 to 27 months, and 28 to 39 months. Comparisons were made using a 2-sample t test, and the exposure-outcome relationship was explored using a generalized linear mixed model with a Poisson distribution. Results: Over the course of 978,364 patient days, 150,258 patients utilized 652,053 UC-days. The rates of CAUTI per 1,000 UC days were measured. The rates decreased from 14.89 during the baseline period to 5.51 in the second month (risk ratio [RR] = 0.37; 95% confidence interval [CI] = 0.34-0.39; P < .001), 3.79 in the third month (RR = 0.25; 95% CI = 0.23-0.28; P < .001), 2.98 in the 4 to 15 months (RR = 0.21; 95% CI = 0.18- 0.22; P < .001), 1.86 in the 16 to 27 months (RR = 0.12; 95% CI = 0.11-0.14; P < .001), and 1.71 in the 28 to 39 months (RR = 0.11; 95% CI = 0.09-0.13; P < .001). Conclusions: Our intervention, without substantial costs or additional staffing, achieved an 89% reduction in CAUTI incidence in ICUs across 32 countries, demonstrating feasibility in ICUs of low- and middle-income countries.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Hospital infection Health care–associated infection Device-associated infection Limited resources countries Low-income countries
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care Kulliyyah of Medicine
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	28 Oct 2024 09:03
Last Modified:	28 Oct 2024 09:03
URI:	http://irep.iium.edu.my/id/eprint/115297

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