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1. International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, and Gunes, M

Subjects
infection, Surgical wound infection, Developing countries, Hospital infection, Nosocomial infection, Health care-associated
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

2. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A., Sirmatel, F., Oztoprak, N., Koksal, I., Oncul, O., Gurbuz, Y., Güçlü, E., Turgut, H., Yalcin, A.N., Ozdemir, D., Kendirli, T., Aslan, T., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Ozgunes, I., Usluer, G., Otkun, M., Kaya, A., Kuyucu, N., Kaya, Z., Meric, M., Azak, E., Yýlmaz, G., Kaya, S., Ulusoy, H., Haznedaroglu, T., Gorenek, L., Acar, A., Tutuncu, E., Karabay, O., Kaya, G., Sacar, S., Sungurtekin, H., Uğurcan, Doğaç, Turhan, O., Gumus, E., Dursun, O., Geyik, M.F., Şahin, A., Erdogan, S., Ince, E., Karbuz, A., Çiftçi, E., Taşyapar, N., and Güneş, M.

Subjects
Turkey, Surgical wound infection, Health careeassociated infection, prevalence, infection rate, surgical infection, Article, Turkey (republic), Developing countries, Cohort Studies, hip prosthesis, Nosocomial infection, coronary artery bypass graft, Humans, Hospital infection, human, Prospective Studies, hospital, Cities, cesarean section, craniotomy, clinical trial, cohort analysis, shunting, Hospitals, hospital patient, multicenter study, city, prospective study
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

3. report on device-associated infection rates in 19 cities of Turkey, data

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Atasay, B, Erbay, A, Unal, S, Senol, G, Willke, A, Ozgultekin, A, Altin, N, Bakir, M, Oncul, O, Ersoz, G, Ozdemir, D, Yalcin, AN, Ozdemir, H, Yildizdas, D, Koksal, I, Aygun, C, Sirmatel, F, Sener, A, Tuna, N, Akan, OA, Turgut, H, Demiroz, AP, Kendirli, T, Alp, E, Uzun, C, Ulusoy, S, Arman, D, Ozgunes, I, Usluer, G, Kilic, A, Arsan, S, Cabadak, H, Sen, S, Gelebek, Y, Zengin, H, Topeli, A, Alper, Y, Meric, M, Azak, E, Inan, A, Turan, G, Haznedaroglu, T, Gorenek, L, Acar, A, Cesur, S, Engin, A, Kaya, A, Kuyucu, N, Geyik, MF, Aydin, OC, Erdogan, NS, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Gokmen, Z, Ozdemir, SI, Horoz, OO, Yylmaz, G, Kaya, S, Ulusoy, H, Kucukoduk, S, Ustun, C, Baysal, AI, Otkun, M, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Yetkin, MA, Bulut, C, Erdinc, FS, Hatipoglu, CA, Ince, E, Ciftci, E, Odek, C, Yaman, A, Karbuz, A, Aldemir, B, Kilic, AU, Arda, B, Bacakoglu, F, and Hizel, K

Subjects
infection, Urinary tract infection, Network, Ventilator-associated pneumonia, Catheter-associated urinary tract, health care facilities, manpower, and services, Central line-associated bloodstream infections, Bloodstream, VELOPING-COUNTRIES, MULTIDIMENSIONAL APPROACH, STRATEGY, IMPACT, INICC, International Nosocomial Infection Consortium, Turkey, Device-associated infection, Antibiotic resistance, Hospital infection, Nosocomial infection, Healthcare-associated
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.

Published
2014

4. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Atasay, B., Erbay, A., Unal, S., Senol, G., Willke, A., Özgültekin, A., Altin, N., Bakir, M., Oncul, O., Ersöz, G., Ozdemir, D., Yalcin, A.N., Özdemir, H., Yıldızdaş, D., Koksal, I., Aygun, C., Sirmatel, F., Sener, A., Tuna, N., Akan, Ö.A., Turgut, H., Demiroz, A.P., Kendirli, T., Alp, E., Uzun, C., Ulusoy, S., Arman, D., Ozgunes, I., Usluer, G., Kiliç, A., Arsan, S., Cabadak, H., Sen, S., Gelebek, Y., Zengin, H., Topeli, A., Alper, Y., Meric, M., Azak, E., İnan, A., Turan, G., Haznedaroglu, T., Gorenek, L., Acar, A., Cesur, S., Engin, A., Kaya, A., Kuyucu, N., Geyik, M.F., Aydın, Ö.Ç., Erdogan, N.S., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Gökmen, Z., Özdemir, S.İ., Horoz, O.O., Yýlmaz, G., Kaya, S., Ulusoy, H., Küçüködük, S., Ustun, C., Otkun, M., Tulunay, M., Oral, M., Ünal, N., Cengiz, M., Yilmaz, L., Sacar, S., Sungurtekin, H., Uğurcan, D., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., İnce, E., Çiftçi, E., Ödek, Ç., Yaman, A., Karbuz, A., Aldemir, B., Kılıc, A.U., Arda, B., Bacakoglu, F., and Hizel, K.

Subjects
Male, Turkey, healthcare associated infection, Antibiotic resistance, health care facilities, manpower, and services, central venous catheter, Network, intensive care unit, preschool child, Turkey (republic), Cohort Studies, Nosocomial infection, newborn, device infection, Prevalence, Prospective Studies, Child, intensive care, catheter infection, Urinary tract infection, Cross Infection, adult, Pneumonia, Ventilator-Associated, INICC, cohort analysis, infection control, Device-associated infection, female, Equipment and Supplies, Child, Preschool, disease surveillance, devices, prospective study, Adolescent, Catheter-associated urinary tract infection, infection rate, Bloodstream infection, Article, critically ill patient, length of stay, Ventilator-associated pneumonia, Humans, Hospital infection, human, Healthcare-associated infection, urinary catheter, Infant, Newborn, Infant, International Nosocomial Infection Consortium, mechanical ventilator, major clinical study, mortality, Catheter-Related Infections, ventilator associated pneumonia, Central line-associated bloodstream infections
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report. © 2014 Leblebicioglu et al.

Published
2014

5. Control Consortium findings (INICC)

Author

Leblebicioglu, H, Ersoz, G, Rosenthal, VD, Nevzat-Yalcin, A, Akan, OA, Sirmatel, F, Turgut, H, Ozdemir, D, Alp, E, Uzun, C, Ulusoy, S, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Kaya, A, Kuyucu, N, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Geyik, MF, Sahin, A, Erdogan, S, Aygen, B, Arda, B, and Bacakoglu, F

Subjects
infections, Urinary catheter, Developing countries, Limited resources, Hospital infection, Nosocomial infection, Health care-acquired, Critical care, Incidence density, Bundle, Hand hygiene, Handwashing, infection, Device-associated infection, Catheter-related urinary tract, countries, Low-income countries, Emerging countries, Surveillance
Abstract

Background: We evaluate the effectiveness of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infections (CAUTIs) in 13 intensive care units (ICUs) in 10 hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of Turkey. Methods: A before-after prospective active surveillance study was used to determine rates of CAUTI. The study was divided into baseline (phase 1) and intervention (phase 2). In phase 1, surveillance was performed applying the definitions of the Centers for Disease Control and Prevention/National Healthcare Safety Network. In phase 2, we implemented a multidimensional approach that included bundle of infection control interventions, education, surveillance and feedback on CAUTI rates, process surveillance, and performance feedback. We used random effects Poisson regression to account for clustering of CAUTI rates across time periods. Results: The study included 4,231 patients, hospitalized in 13 ICUs, in 10 hospitals, in 10 cities, during 49,644 patient-days. We recorded a total of 41,871 urinary catheter (UC)-days: 5,080 in phase 1 and 36,791 in phase 2. During phase 1, the rate of CAUTI was 10.63 per 1,000 UC-days and was significantly decreased by 47% in phase 2 to 5.65 per 1,000 UC-days (relative risk, 0.53; 95% confidence interval: 0.4-0.7; P value = .0001). Conclusion: Our multidimensional approach was associated with a significant reduction in the rates of CAUTI in Turkey. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2013

6. International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

Author

Rosenthal, V.D., Bijie, H., Maki, D.G., Mehta, Y., Apisarnthanarak, A., Medeiros, E.A., Leblebicioglu, H., Fisher, D., Álvarez-Moreno, C., Khader, I.A., Martínez, M.D.R.G., Cuellar, L.E., Navoa-Ng, J.A., Abouqal, R., Garcell, H.G., Mitrev, Z., García, M.C.P., Hamdi, A., Dueñas, L., Cancel, E., Gurskis, V., Rasslan, O., Ahmed, A., Kanj, S.S., Ugalde, O.C., Mapp, T., Raka, L., Meng, C.Y., Thu, L.T.A., Ghazal, S., Gikas, A., Narváez, L.P., Mejía, N., Hadjieva, N., Elanbya, M.O.G., Siritt, M.E.G., Jayatilleke, K., Frías, M.L., Churruarín, G., Sztokhamer, D., Flynn, L.P., Rausch, D., Spagnolo, A., Santero, B., Soroka, L.C., For-Ciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Bedoya, M.Á.F., Costamagna, A., Dheza, G.R., Ávalos, J., Álvarez, M., Bench-Etrit, G., Bonaventura, C., Caridi, M.Á., Messina, A., Ricci, B., Viegas, M., Di Núbila, B.M.A., Lan-Zetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Bernan, M.L., Bay, M.R., Diaz, F.R., Dominguez, C.B., Coria, G.E., Martinelli, M.E., Grinberg, G., Ferreira, I.B., Cechinel, R.B., Zanandrea, B.B., Rohnkohl, C., Regalin, M., Spessatto, J.L., Pasini, R.S., Ferla, S., Salomao, R., da Silva, M.Â.M., de Jesus Silva, C.H., Vilins, M., Blecher, S., Angelieri, D.B., Kuchenbecker, R.S., Pires, M.R., Santos, R.P., Kuplich, N.M., Siliprandi, E.M.O., Do-Amaral, A.P., Silva, C.P.R., Biancalana, M.L.N., Sánchez, T.E.G., Valente, R., Apolinário, D., Freitas, L.F.B., Dos Santos, M.C.I., Lopes, J.M.M., Valadares, P.C.P., Batista, J.P., Campos, M.A.-E.S., Moretti, M.L., Cardoso, L.G., Trabaos, A., Martins, I.S., Santos, P.T.D., Pinhejro, D.O.B.P., Abreu, J.S.D., Richtmann, R., Rodríguez, T., Baltieri, S.R., Moreira, M., Stadtlober, G.F., Cavaglieri, A.G., Karadimovm, D., Velinova, V., Qin, J.A., Juan, H., Fang, H.C., Gao, X., Lili, T., Yao, S., Hungmei, W., Bin, C., Ruisheng, L., Yang, Y., Yeguxiang, Ziqin, X., Mei, W.H., Chun, G.S., Yang, X., Gan, A., Zhang, A., Luo, J., Zhao, A., Li, F., Liu, B., Gao, M., Zhao, B., Wei, L., Wang, C., Fang, L., Yi, C., Xie, X., Ling, F., Wu, Y., Xu, F., Feng, F., Weng, F., Dong, G.-H., Ye, G., Yang, W., Yu, H., Yang, H.-I., Yan, H., Mao, A., Zhou, H., Chen, W., Gong, H., Tan, H., Liu, Y., Wu, H., Tang, D., Hao, J., Zhang, H., Wang, J., Qiu, Y., Yu, J., Gu, X., Jiang, J., Zhang, M., Miu, J., Zhao, W., Shi, J., Li, L., Duo, K., Cai, L., Liu, L., Hua, L., Shao, Q., An, Y., Lu, Q., Li, G., Sun, R., Zhang, W., Tao, Z., Wang, W., Shen, Y., Fan, W., Chen, H., Yao, X., Wen, H., Xiong, X., Xu, H., Liu, X., Huang, M., Wang, X., Shao, G., Yuan, Y., Cao, Y., Chen, Y., Chen, X., Gu, Y., Zhu, L., Huang, Y., Wang, M., Wang, Y., Mao, Y., Cheng, Y., Zhao, C., Sun, Y., Zhu, B., Cai, M., Zhang, Y., Xue, M., Zhou, Y., Zhang, R., Du, Y., Li, D., Ni, Y., Zhang, L., Zhong, Z., Zhu, G., Yu, Z., Cao, M., Song, Z., Xu, J., Tong, Z., Gu, P., Agudelo, J.G., Sussmann, O., Mojica, B.E., Rojas, C., Beltran, H., Paez, J., Gómez, W.V., Dajud, L., Mendoza, M., Arrieta, P., Osorio, L., Olarte, N., Valderrama, A., Muñoz, H.J., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Linares, C., Cortés, L.M., Campo, L.F.R., Menco, A., Calderón, M.E.R., Parada, D.E.C., Fernandez, A.M.P., Martínez, I.F.P., Saleg, P.A.M., Vega, Y.L., Luengas, E.L., Ramos, C.R., Hernández, H.T., Gomez, D.Y., Gomez, B.M.V., Ruiz, M.G., Millán, J.C.T., López, M.U.T., Parada, E.C., Rochel, A.E.M., Hidalgo, R.F., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Chinchilla, A.S., Fuentes, C.G., Pérez, C.M., Pino, O.R., González, O.D., González, D.F., de Wang, C.M.R., Severino, R., Tolari, G., Delgado, M., Vélez, J.W., Zapata, M.A.C., Valle, M.J., Guayasamín, S., Seliem, Z.S., El Kholy, A.A., Abdel-Aziz, D., Sabour, M.A.E., Kalil, M., Saeed, A., Gafarey, M.E., Fouad, L., Muhamed, T., Saeed, H., Casares, A.C.B., Machuca, L.J., Chaniotaki, K., Tsioutis, C., Bampalis, D., Gopinath, R., Ravindra, N., Karlekar, A., Sood, S., Verma, N., Sen, N., Subramani, K., Raj, J.P., Mathur, P., Kumar, S., Sahu, S., Govil, D., Jaggi, N., Bhatnagar, S., Myatra, S.N., Divatia, Kelkar, R., Biswas, S., Raut, S., Sampat, S., Kumar, R., Todi, S.K., Bhakta, A., Bhattacharjee, M., Ramachandran, B., Chakravarthy, M., Gokul, B.N., Sukanya, R., Pushparaj, L., Singh, S., Radhakrishnan, K., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Jadhav, S., Dwivedy, A., Shetty, S., Binu, S., Pawar, M., Gupta, A., Saini, N., Kothari, V., Singhal, T., Shah, S., Rodrigues, C., Hegd, A., Kapadia, F., Mehta, P., Surase, P., Narayanan, S., Munshi, N., Padbidri, V., Dawhale, R., Jacobs, S.M., Khuri-Bulos, N., Mahafzah, A., Baftiu, N., Spahija, G., Zahreddine, N., Alamuddin, L., Kanafani, Z., Dagys, A., Kondratas, T., Kevalas, R., Anguseva, T., Ampova, V., Guroska, S.T.-C., Manikavasagam, J., Tan, L.H., Kaur, K., Assadian, O., Wolfram, R., Kaur, P., Oropeza, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Serrato, I.P., López, M.S., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Gallo, J.H.P., Almazán, F.A., Miramontes, G.I., Vázquez Olivas, M.D.R., Chávez, A.S., Espinoza, Y.A., Gallegos, L.A., González, D.J.S., Rochín, A.M., Félix, M.J.S., Peña, R.D., Gómez, A.B.Z., Gutiérrez, C.A.E., Novales, M.G.M., Herver, M.D.J., Gaytan, J.A., Olmeda, J.A.G., Martínez-Marroquín, M.Y., Hernández, A., García, E.O., Cervantes, R.V., Arteaga-Troncoso, G., Guerra Infante, F.M., Méndez, I.M., Burguete, M.C.C., Barkat, A., Bouazzaoui, N.L., Meryem, K., Madani, N., Zeggwagh, A.A., Abidi, K., Dendane, T., Khan, S.G., Ali, F., Hussain, Y., Butt, F., Fakir, A., Mahmood, S.F., Jamil, B., Memon, B.A., Bhutto, G.H., Alfaro, F.G., Alvarado, C., León, L.M.D., Navarro, R., Moreno, J.L., Cerrad, R., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Espinoza, T.A., López, F.S., Saldarriaga, M.E.C., Morvelí, E.U.V., Barriga, H., Villacorta, M.S., Barrios, S.C., Zegarra, S.L.T., Astete, N.S., Guevara, F.C., Mendoza, C.B., Ramírez, A.V., Pastrana, J.S., Wong, F.M.R., Ángeles, C.S., Tavera, Z.D., Ramirez, E., Vergara, C.E.L.H., Mendoza, L., Sosa, G.B., Chávez, C.M., Berba, R., Genuino, G.A.S., Consunji, R.J., Mantaring, J.B.V., III, Villanueva, V.D., Tolentino, M.C.V., Galapia, Y.A., Tambyah, P.A., Hakawi, A., Kaluarachchi, N.N., Samaraweera, G.A.-R., Sid Ahmed Ali, I.M., Satti, A.A., Jamulitrat, S., Thamlikitkul, V., Ben-Jaballah, N., Ammar, K., Öztürk, R., Dikmen, Y., Aygún, G., Ulusoy, S., Arda, B., Bacakoglu, F., Sardan, Y.C., Yildirim, G., Topeli, A., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Alp, E., Aygen, B., Sirmatel, F., Cengiz, M., Yilmaz, L., Özgültekin, A., Turan, G.-D., Akgün, N., Ozdemir, D., Guclu, E., Erdogan, S., Erben, N., Ozgunes, I., Usluer, G., Aygun, C., Küçüködük, S., Arman, D., Hizel, K., Uzun, C., Turgut, Hüseyin, Saçar, Suzan, Sungurtekin, Hülya, Uğurcan, Doğaç, Koksal, I., Yýlmaz, G., Kaya, S., Ulusoy, H., Ersoz, G., Kaya, A., Kuyucu, N., Esen, S., Ulger, F., Dilek, A., Yalcin, A.N., Turhan, O., Keskin, S., Gumus, E., Dursun, O., Kendirli, T., Ince, E., Cliftci, E., Özdemir, H., Demiroz, A.P., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., Erbay, A., Willke, A., Meric, M., Azak, E., Oncul, O., Haznedaroglu, T., Gorenek, L., Acar, A., Silvera, E., Techera, S., Frachia, A., Algorta, G., Gil de Añez, Z.D., Bravo, L.M., Orozco, N., Mejías, E., Trang, D.T.V., Nga, T.T.K., and Zruong, P.H.

Subjects
meticillin, Staphylococcus aureus, Asia, Antibiotic resistance, Health care-associated infection, Catheter-associated urinary tract infection, Network, bloodstream infection, intensive care unit, Developing countries, South and Central America, Nosocomial infection, Escherichia coli, Ventilator-associated pneumonia, Hospital infection, human, ceftazidime, catheter infection, Urinary tract infection, nonhuman, bacterium isolate, article, developing country, infection control, mortality, Device-associated infection, Low-income countries, hospital bed, Europe, Klebsiella pneumoniae, Central line-associated bloodstream infection, Africa, Pseudomonas aeruginosa, Limited-resources countries, disease surveillance, ventilator associated pneumonia, hospitalization, prospective study
Abstract

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2012

7. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Ahmet Şahin, Iftihar Koksal, Gaye Usluer, Hülya Sungurtekin, Tanıl Kendirli, Selçuk Kaya, Eylul Gumus, Gürdal Yýlmaz, Mehmet Faruk Geyik, Ertugrul Guclu, Nurettin Erben, Tuna Demirdal, Tuncer Haznedaroglu, Huseyin Turgut, Levent Gorenek, Erdal Ince, Melek Güneş, Hava Yilmaz, Necdet Kuyucu, Suzan Sacar, Alper Şener, Oguz Dursun, Nefise Oztoprak, Ahmet Dilek, Fatma Sirmatel, Ergin Çiftçi, Meliha Meric, Gulsume Kaya, Mustafa Sunbul, Metin Otkun, Emel Azak, Fatma Ülger, Gülden Ersöz, Yunus Gürbüz, Ayşe Willke, Sehnaz Kaya, Hakan Leblebicioglu, Oral Oncul, Davut Ozdemir, Nevin Taşyapar, Ali Acar, Ediz Tutuncu, Zeynep Kaya, Doğaç Uğurcan, Oguz Karabay, Victor D. Rosenthal, Fazilet Duygu, Saban Esen, Ali Kaya, Ata Nevzat Yalcin, Hülya Ulusoy, Gunes Senol, Adem Karbuz, Turan Aslan, Özge Turhan, Selvi Erdogan, Cengiz Uzun, Ilhan Ozgunes, Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, Gunes, M, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, MERİÇ KOÇ, MELİHA, and Ondokuz Mayıs Üniversitesi

Subjects
Turkey, Epidemiology, Surgical wound infection, Health careeassociated infection, Turkey (republic), Cohort Studies, hip prosthesis, Nosocomial infection, Prospective Studies, hospital, Prospective cohort study, Health Policy, craniotomy, clinical trial, cohort analysis, Hospitals, hospital patient, Infectious Diseases, Cohort, Surgical site infection, Cohort study, prospective study, medicine.medical_specialty, Health care-associated infection, prevalence, education, infection rate, surgical infection, Article, Developing countries, coronary artery bypass graft, Internal medicine, medicine, Humans, Hospital infection, human, Cities, cesarean section, business.industry, Public Health, Environmental and Occupational Health, findings of the International Nosocomial Infection Control Consortium (INICC)-, AMERICAN JOURNAL OF INFECTION CONTROL, cilt.43, ss.48-52, 2015 [Leblebicioglu H., Erben N., ROSENTHAL V. D. , ŞENER A., UZUN C., SENOL G., Ersoz G., Demirdal T., DUYGU F., Willke A., et al., -Surgical site infection rates in 16 cities in Turkey], Nosocomial infection control, Confidence interval, shunting, Surgery, Clinical trial, multicenter study, city, business
Abstract

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

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