Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe

Rosenthal, Victor Daniel and Jin, Zhilin and Yin, Ruijie and Sahu, Suneeta and Rajhans, Prasad and Kharbanda, Mohit and Nair, Pravin K. and Mishra, Shakti Bedanta and Chawla, Rajesh and Mat Nor, Mohd Basri (2024) Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe. Journal of Critical Care, 80. ISSN 0883-9441 E-ISSN 1557-8615

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Abstract

Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P < 0.001); 11.40 at the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P < 0.001), and to 9.68 at the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. Conclusions: This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Hospital infection, Nosocomial infection, Healthcare-associated infection, Device-associated infection, Ventilator-associated pneumonia, Developing countries, Limited resources countries, Low-income countries, Network
Subjects:	R Medicine > RC Internal medicine > RC731 Specialties of Internal Medicine-Diseases of The Respiratory System 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 Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	29 Oct 2024 16:30
Last Modified:	29 Oct 2024 16:30
URI:	http://irep.iium.edu.my/id/eprint/115394

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