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17 results on '"Lourdes Dueñas"'

1. Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network

Author

Tamara Viviani, Emelia Bainto, Fernanda Cofré, Elizabeth Moreno, Olguita Del Aguila, Dora Estripeaut, Sandra Beltrán, Rolando Ulloa-Gutierrez, Lucila Martínez-Medina, Kathia Luciani, Luis Martín Garrido-García, S Diana Garcia, Martha I Alvarez-Olmos, María Catalina Pírez, Adriana H. Tremoulet, Virgen Gómez, Eduardo López-Medina, Andrea Salgado, Enrique Faugier-Fuentes, Greta Miño-León, Heloisa Helena de Souza Marques, Germán Camacho-Moreno, Patricia Saltigeral-Simental, Benjamin D Rosellini, Lourdes Dueñas, Austin J. Parish, and Francisco J Rodríguez-Quiroz

Subjects
Pediatrics, medicine.medical_specialty, Latin Americans, Clinical Trials and Supportive Activities, 030204 cardiovascular system & hematology, Delayed diagnosis, Paediatrics and Reproductive Medicine, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, 030225 pediatrics, medicine, coronary artery abnormalities, Vulnerable population, delayed diagnosis, Original Research, Coronary artery aneurysm, Pediatric, Other Medical and Health Sciences, Kawasaki disease, infants, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Brain Disorders, medicine.anatomical_structure, Latin America, Multicenter study, Pediatrics, Perinatology and Child Health, Presentation (obstetrics), business, Coronary artery abnormalities, Infants, Artery, The REKAMLATINA-2 Study Group Investigators
Abstract

Objective: To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants 10 days (50 vs. 7.4%, P = 0.043)]. Conclusion: Our data show that despite treatment in the first 10 days of illness, infants

Published
2020
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2. Use of adjunctive therapy in acute Kawasaki disease in Latin America

Author

Brenda Fortuna-Reyna, Emelia V. Bainto, Rolando Ulloa-Gutierrez, Luis M. Garrido-García, Dora Estripeaut, Olguita del Águila, Virgen Gómez, Enrique Faugier-Fuentes, Greta Miño-León, Sandra Beltrán, Fernanda Cofré, Enrique Chacón-Cruz, Patricia Saltigeral-Simental, Lucila Martínez-Medina, Lourdes Dueñas, Kathia Luciani, Francisco J. Rodríguez-Quiroz, German Camacho-Moreno, Tamara Viviani, Martha I. Alvarez-Olmos, Heloisa Helena de Sousa Marques, Eduardo López-Medina, María C. Pirez, and Adriana H. Tremoulet

Subjects
medicine.medical_specialty, Latin Americans, Future studies, adjunctive therapy, Pediatrics, Paediatrics and Reproductive Medicine, Rare Diseases, Internal medicine, medicine, Adjunctive therapy, Original Research, Other Medical and Health Sciences, Kawasaki disease, business.industry, Kawasaki Disease REKAMLATINA Network Study Group, lcsh:RJ1-570, Evaluation of treatments and therapeutic interventions, lcsh:Pediatrics, medicine.disease, Infliximab, Coronary arteries, medicine.anatomical_structure, Latin America, 6.1 Pharmaceuticals, Pediatrics, Perinatology and Child Health, Steroids, business, infliximab, medicine.drug, steroids
Abstract

Objective: To characterize the use of adjunctive therapy in Kawasaki disease (KD) in Latin America. Methods: The study included 1,418 patients from the Latin American KD Network (REKAMLATINA) treated for KD between January 1, 2009, and May 31, 2017. Results: Of these patients, 1,152 received only a single dose of IVIG, and 266 received additional treatment. Age at onset was similar in both groups (median 2 vs. 2.2 years, respectively). The majority of patients were male (58 vs. 63.9%) and were hospitalized with the first 10 days of fever (85.1 vs. 84.2%). The most common adjunctive therapy administered was steroids for IVIG-resistance, followed by additional doses of IVIG. The use of biologics such as infliximab was limited. KD patients who received adjunctive therapy were more likely to have a lower platelet count and albumin level as well as a higher Z score of the coronary arteries. Conclusion: This is the first report of adjunctive therapies for KD across Latin America. IVIG continues to be the initial and resistance treatment, however, steroids are also used and to a lesser extent, biological therapy such as infliximab. Future studies should address the barriers to therapy in children with acute KD throughout Latin America.

Published
2020

3. Epidemiología del dengue en Centroamérica y República Dominicana

Author

Mario Melgar, Lourdes Dueñas, Marco Luque, Crisanta Rocha, Lizbeth Cerezo, José Brea-Del-Castillo, Kattia Camacho-Badilla, and María L Avila-Aguero

Subjects
0301 basic medicine, medicine.medical_specialty, República Dominicana, 030106 microbiology, Centroamérica, incidencia, Dengue fever, Dengue, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, 030212 general & internal medicine, epidemiología, Population statistics, Incidence (epidemiology), Public Health, Environmental and Occupational Health, Census, medicine.disease, Sub region, Infectious Diseases, Geography, Health organization, High incidence, letalidad, Demography
Abstract

Resumen Introducción: Centroamérica experimenta una alta carga de la enfermedad por dengue aportando cerca de 8% de todos los casos del continente. Este trabajo reporta la epidemiología del dengue en la subregión en un período de 10 años. Objetivos: Documentar la epidemiología del dengue en Centro América y República Dominicana. Material y Métodos: Período de estudio: años 2005-2014. Se recopilaron y analizaron los datos de casos y muertes por dengue de los países de Centro América y República Dominicana, reportados por los Ministerios de Salud y se corroboró con los datos publicados en los boletines en línea y la base de datos interactiva de la Organización Panamericana de la Salud (OPS). Se obtuvieron estadísticas poblacionales de los Institutos Nacionales de Estadística y Censo de cada país. Resultados: Durante el período de estudio fueron notificados 1.118.464 casos de dengue. Reportados 32.431 casos graves, 888 personas fallecidas. La letalidad por caso de dengue fue en promedio 0,08%. Los cuatro serotipos de dengue circularon durante el decenio estudiado. Discusión: La información clínica y epidemiológica, indica tasas de incidencia alta, que han fluctuado en los últimos años, con co-circulación significativa de varios serotipos a la vez. Conclusiones: Se identificaron diferencias notorias en la recolección de datos de la vigilancia entre países. Se determinó un patrón epidemiológico heterogéneo.

Published
2019

4. Congenital and perinatal complications of chikungunya fever: a Latin American experience

Author

José Brea del Castillo, Jorge Pleitez-Navarrete, Lourdes Dueñas, Luiza Helena Falleiros-Arlant, Jaime R. Torres, and Doris M. Salgado

Subjects
Male, Pediatrics, Complications, medicine.disease_cause, Disease Outbreaks, Congenital, 0302 clinical medicine, Pregnancy, Case fatality rate, Epidemiology, Medicine, Prospective Studies, 030212 general & internal medicine, Chikungunya, Pregnancy Complications, Infectious, Incidence, Incidence (epidemiology), Pregnancy Outcome, Meningoencephalitis, General Medicine, Infectious Diseases, Female, Chikungunya virus, Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, Genotype, Pregnancy Trimester, Third, 030231 tropical medicine, Lymphocytic pleocytosis, Mothers, Perinatal, lcsh:Infectious and parasitic diseases, Young Adult, 03 medical and health sciences, Humans, lcsh:RC109-216, business.industry, Infant, Newborn, Infant, Outbreak, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Latin America, Chikungunya Fever, business
Abstract

Summary Background During the years 2014 and 2015, the Region of the Americas underwent a devastating epidemic of chikungunya virus (CHIKV) of the Asian genotype, resulting in millions of affected individuals. However, epidemiological and clinical information on this experience is scarce. Prior knowledge of congenital and neonatal illness caused by CHIKV is limited and almost exclusively based on data obtained from a single outbreak of the East/Central/South African (ECSA) genotype. The effect of chikungunya fever (CHIKF) on pregnancy outcomes and its consequences for infants born to infected mothers at the peak of the epidemic wave in Latin America are reviewed herein. Epidemiological and clinical data on maternal and neonatal infections were collected prospectively and analyzed. Methods One hundred sixty-nine symptomatic newborns with CHIKF seen at four large regional maternity hospitals in three different Central and South American countries were evaluated prospectively. The outcomes of pregnancies in symptomatic infected mothers at two of these clinical centers were also analyzed. Results The observed vertical transmission rate ranged between 27.7% and 48.29%. The incidence of congenital disease was unrelated to the use of cesarean section or natural delivery. The case fatality rate (CFR) at the only center that reported deaths was 5.3%. The most common clinical manifestations included fever, irritability, rash, hyperalgesia syndrome, diffuse limb edema, meningoencephalitis, and bullous dermatitis. Severe complications included meningoencephalitis, myocarditis, seizures, and acute respiratory failure. Leukocytosis with neutrophilia and normal or increased platelets was a common finding, and in those with signs of meningeal involvement, moderate lymphocytic pleocytosis with normal glucose and protein levels was typical. Conclusions This study presents the largest number of symptomatic neonates with CHIKF analyzed so far in any region and is the first involving infection with the Asian genotype of CHIKV. Although the clinical manifestations found were similar to those reported previously, the percentage of neurological complications was lower. The CFR was comparatively high. Chikungunya represented a substantial risk for neonates born to symptomatic parturients during the chikungunya outbreak in the Americas Region, with important clinical and public health implications.

Published
2016
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5. Abstract O-59

Author

Patricia Saltigeral-Simental, Germán Camacho-Moreno, Kattia Camacho-Badilla, Dora Estripeaut, Rolando Ulloa-Gutierrez, Marco Antonio Yamazaki-Nakashimada, M. Vargas-Gutierrez, Francisco J Rodríguez-Quiroz, Adriana H. Tremoulet, Kathia Luciani, Alejandra Soriano-Fallas, Lourdes Dueñas, R. Rodríguez-Herrera, Andrea Salgado, María L Avila-Aguero, O. del Águila, S. Li-Chan, Luis Martín Garrido-García, and Virgen Gómez

Subjects
Pediatrics, medicine.medical_specialty, Latin Americans, business.industry, Shock (circulatory), Pediatrics, Perinatology and Child Health, medicine, Kawasaki disease, medicine.symptom, Critical Care and Intensive Care Medicine, medicine.disease, business
Published
2018
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6. Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries

Author

Yamileth Astudillo, Guillermo Sarmiento-Villa, M. Pawar, Nurgul Gunay, María Corazon V Tolentino, Jorge Mena-Brito, Roberto Campuzano, Carlos Alvarez-Moreno, Gülden Ersöz, Luis F. Rendón-Campo, Lourdes Dueñas, Lilian de Jesús-Machuca, Amit Gupta, Marena Rodríguez-Ferrer, Claudia Linares, Josephine Anne Navoa-Ng, Özge Turhan, Necdet Kuyucu, Eylul Gumus, Ali Kaya, Narinder Saini, Lorena Matta-Cortés, Bala Ramachandran, A. Nevzat-Yalcin, Nayide Barahona-Guzmán, Victor D. Rosenthal, Alfredo Lagares-Guzmán, Victoria D. Villanueva, Oguz Dursun, Alberto Armas-Ruiz, and Ana Concepción Bran de Casares

Subjects
Microbiology (medical), medicine.medical_specialty, Epidemiology, media_common.quotation_subject, MEDLINE, Developing country, Intensive Care Units, Pediatric, Hospitals, Urban, Hygiene, Intensive care, medicine, Humans, Infection control, Prospective Studies, Intensive care medicine, Prospective cohort study, Developing Countries, media_common, Catheter-associated urinary tract infection, Cross Infection, business.industry, Congresses as Topic, Nosocomial infection control, Infectious Diseases, Catheter-Related Infections, Population Surveillance, Urinary Tract Infections, Guideline Adherence, business, Hand Disinfection
Abstract

Design.A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.Setting.Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.Patients.PICU inpatients.Methods.We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.Results.During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21–1.0]), indicating a rate reduction of 57%.Conclusions.Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.

Published
2012
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7. Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries

Author

Victor D, Rosenthal, William R, Jarvis, Silom, Jamulitrat, Cristiane Pavanello Rodrigues, Silva, Bala, Ramachandran, Lourdes, Dueñas, Vaidotas, Gurskis, Gulden, Ersoz, María Guadalupe Miranda, Novales, Ilham Abu, Khader, Khaldi, Ammar, Nayide Barahona, Guzmán, Josephine Anne, Navoa-Ng, Zeinab Salah, Seliem, Teodora Atencio, Espinoza, Cheong Yuet, Meng, Kushlani, Jayatilleke, and Oguz, Dursun

Subjects
Pediatrics, medicine.medical_specialty, media_common.quotation_subject, Developing country, Intensive Care Units, Pediatric, Critical Care and Intensive Care Medicine, Hygiene, Intensive care, Health care, Humans, Medicine, Prospective Studies, Prospective cohort study, Developing Countries, media_common, Cross Infection, business.industry, Pneumonia, Ventilator-Associated, Nosocomial infection control, medicine.disease, Pneumonia, Social Class, Catheter-Related Infections, Pediatrics, Perinatology and Child Health, Public hospital, Emergency medicine, Guideline Adherence, business, Hand Disinfection
Abstract

Objectives: We report the results of the International Nosocomial Infection Control Consortium prospective surveillance study from January 2004 to December 2009 in 33 pediatric intensive care units of 16 countries and the impact of being in a private vs. public hospital and the income country level on device-associated health care-associated infection rates. Additionally, we aim to compare these findings with the results of the Centers for Disease Control and Prevention National Healthcare Safety Network annual report to show the differences between developed and developing countries regarding device-associated health care-associated infection rates. Patients: A prospective cohort, active device-associated health care-associated infection surveillance study was conducted on 23,700 patients in International Nosocomial Infection Control Consortium pediatric intensive care units. Methods: The protocol and methodology implemented were developed by International Nosocomial Infection Control Consortium. Data collection was performed in the participating intensive care units. Data uploading and analyses were conducted at International Nosocomial Infection Control Consortium headquarters on proprietary software. Device-associated health care-associated infection rates were recorded by applying Centers for Disease Control and Prevention National Healthcare Safety Network device-associated infection definitions, and the impact of being in a private vs. public hospital and the income country level on device-associated infection risk was evaluated. Interventions: None. Measurements and Main Results: Central line-associated bloodstream infection rates were similar in private, public, or academic hospitals (7.3 vs. 8.4 central line-associated bloodstream infection per 1,000 catheter-days [p < .35 vs. 8.2; p < .42]). Central line-associated bloodstream infection rates in lower middle-income countries were higher than low-income countries or upper middle-income countries (12.2 vs. 5.5 central line-associated bloodstream infections per 1,000 catheter-days [p < .02 vs. 7.0; p < .001]). Catheter-associated urinary tract infection rates were similar in academic, public and private hospitals: (4.2 vs. 5.2 catheter-associated urinary tract infection per 1,000 catheter-days [p = .41 vs. 3.0; p = .195]). Catheter-associated urinary tract infection rates were higher in lower middle-income countries than low-income countries or upper middle-income countries (5.9 vs. 0.6 catheter-associated urinary tract infection per 1,000 catheter-days [p < .004 vs. 3.7; p < .01]). Ventilator-associated pneumonia rates in academic hospitals were higher than private or public hospitals: (8.3 vs. 3.5 ventilator-associated pneumonias per 1,000 ventilator-days [p < .001 vs. 4.7; p < .001]). Lower middle-income countries had higher ventilator-associated pneumonia rates than low-income countries or upper middle-income countries: (9.0 vs. 0.5 per 1,000 ventilator-days [p < .001 vs. 5.4; p < .001]). Hand hygiene compliance rates were higher in public than academic or private hospitals (65.2% vs. 54.8% [p < .001 vs. 13.3%; p < .01]). Conclusions: Country socioeconomic level influence deviceassociated infection rates in developing countries and need to be considered when comparing device-associated infections from one country to another. (Pediatr Crit Care Med 2012; 13:399–406)

Published
2012
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8. A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital

Author

Deo Kumar Srivastava, Gabriela Maron, Randall T. Hayden, Alicia Rodriguez, Jonathan A. McCullers, Blanca Lopez, Lourdes Dueñas, and Miguela A. Caniza

Subjects
medicine.medical_specialty, Hand washing, Nursing staff, Attitude of Health Personnel, Epidemiology, media_common.quotation_subject, Hygiene, Pediatric hospital, medicine, Humans, Intensive care medicine, Developing Countries, media_common, Resource poor, Proper hand, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Hospitals, Pediatric, medicine.disease, Infectious Diseases, Alcohols, Medical emergency, business, Disinfectants, Hand Disinfection
Abstract

Background Resource-poor hospitals have many barriers to proper hand hygiene (HH). Alcohol-based HH can compensate for inadequate infrastructure and supplies. We describe the implementation of alcohol-based HH in five high-risk wards of a pediatric hospital in El Salvador. Methods In 5 high-risk wards for nosocomial infections, we evaluated the accessibility, supplies, and cleanliness of the hand-washing sinks at 132 time points. We then installed gel dispensers, identified a local gel supplier, and trained nursing staff to maintain the dispensers. We evaluated user acceptance, costs, and the practice and technique of HH before and after installation. Results Access and cleanliness were adequate at 18.9% and 11.3% of observation points, and towels and soap were available at 61.3% and 93.18% of points. Placement of 35 gel dispensers increased the ratio of HH stations to beds from 1:6.2 to 1:1.8. Alcohol gel was better tolerated than hand washing among 60 surveyed staff. Installation cost $2558 (US) and the monthly gel supply, $731 (US). HH practice increased from 33.8% to 40.5%; use of correct technique increased from 73.8% to 95.2%. Conclusion Alcohol gel can address some of the barriers to effective HH at resource-poor institutions, and its cost may be offset by reduction of nosocomial infection.

Published
2009
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9. Kawasaki Disease (KD) in Children (Ch) Older Than 5 Years of Age Among 20 Latin American (LA) Countries: A Prospective Multinational Multicenter Study of the REKAMLATINA Network

Author

Rolando Ulloa-Gutierrez, Luis M Garrido-García, Dora Estripeaut, Francisco J Rodríguez, Patricia Saltigeral-Simental, Olguita Del Águila, Greta Miño, Marco T Luque, Adrián Collia, Enrique Faugier-Fuentes, Heloisa Helena De Sousa Marques, Martha I Álvarez-Olmos, Kathia Luciani, María C Pirez, Fernanda Cofre, German Camacho-Moreno, Virgen Gomez, Marco a Yamazaki-Nakashimada, Diana López-Gallegos, Angélica Calvache-Burbano, María L Avila-Aguero, Giannina Izquierdo, Kattia Camacho-Badilla, Alejandra Soriano-Fallas, Kathia Valverde, Raymundo Rodriguez-Herrera, Enrique Chacon-Cruz, Antonio Fernández, Lucila Martínez-Medina, Luisa Berenise Gámez-González, Lourdes Dueñas, Paola Pérez-Camacho, Carlos Grazioso, Lorena Franco, Nora Bueno, Sandra Beltán, Jorge a Vázquez Narváez, Andrea P. Salgado, Adriana H. Tremoulet, and Study Group Members

Subjects
Pediatrics, medicine.medical_specialty, Infectious Diseases, Latin Americans, Oncology, Multicenter study, Multinational corporation, business.industry, medicine, Kawasaki disease, medicine.disease, business
Published
2016
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10. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Author

Víctor Daniel Rosenthal, Dennis George Maki, Yatin Mehta, Hakan Leblebicioglu, Ziad Ahmed Memish, Haifaa Hassan Al-Mousa, Hanan Balkhy, Bijie Hu, Carlos Alvarez-Moreno, Eduardo Alexandrino Medeiros, Anucha Apisarnthanarak, Lul Raka, Luis E. Cuellar, Altaf Ahmed, Josephine Anne Navoa-Ng, Amani Ali El-Kholy, Souha Sami Kanj, Ider Bat-Erdene, Wieslawa Duszynska, Nguyen Van Truong, Leonardo N. Pazmino, Lucy Chai See-Lum, Rosalia Fernández-Hidalgo, Gabriela Di-Silvestre, Farid Zand, Sona Hlinkova, Vladislav Belskiy, Hussain Al-Rahma, Marco Tulio Luque-Torres, Nesil Bayraktar, Zan Mitrev, Vaidotas Gurskis, Dale Fisher, Ilham Bulos Abu-Khader, Kamal Berechid, Arnaldo Rodríguez-Sánchez, Florin George Horhat, Osiel Requejo-Pino, Nassya Hadjieva, Nejla Ben-Jaballah, Elías García-Mayorca, Luis Kushner-Dávalos, Srdjan Pasic, Luis E. Pedrozo-Ortiz, Eleni Apostolopoulou, Nepomuceno Mejía, May Osman Gamar-Elanbya, Kushlani Jayatilleke, Miriam de Lourdes-Dueñas, Guadalupe Aguirre-Avalos, Diego Marcelo Maurizi, Adriana Montanini, Maria Laura Spadaro, Lorenzo Santiago Marcos, Priscila Botta, Florencia Maria Jerez, Maria Constanza Chavez, Lucia Ramasco, Maria Isabel Colqui, Maria Silvia Olivieri, Ana Silvia Rearte, Gladys Edith Correa, Paola Deolinda Juarez, Paola Fabiana Gallardo, Miriam Patricia Brito, Gabriel Horacio Mendez, Julia Rosa Valdez, Lorena Paola Cardena, Jose Maria Harystoy, Gustavo Jorge Chaparro, Claudia Gabriela Rodriguez, Rodolfo Toomey, Maria Caridi, Monica Viegas, Marisa Liliana Bernan, Adriana Romani, Claudia Beatriz Dominguez, Luis Kushner Davalos, Rosana Richtmann, Camila Almeida Silva, Tatiane T. Rodrigues, Amaury Mielle Filho, Ernandi Dagoberto Seerig Palme, Aline Besen, Caroline Lazzarini, Caroline Batista Cardoso, Francisco Kennedy Azevedo, Ana Paula Fontes Pinheiro, Aparecida Camacho, Braulio Matias De Carvalho, Maria Jose Monteiro De Assis, Ana Paula Vasconcelos Carneiro, Maria Lilian Maciel Canuto, Keyla Harten Pinto Coelho, Tamiris Moreira, Agamenon Alves Oliveira, Marcela Maria Sousa Colares, Marcia Maria De Paula Bessa, Tereza De Jesus Pinheiro Gomes Bandeira, Renata Amaral De Moraes, Danilo Amâncio Campos, Tânia Mara Lima De Barros Araújo, Maria Tereza Freitas Tenório, Simone Amorim, Manuela Amaral, Julianne Da Luz Lima, Lindalva Pino Da Silva Neta, Caphiane Batista, Fabio Jorge De Lima Silva, Maria C. Ferreira De Souza, Katia Arruda Guimaraes, Julia Marcia Maluf Lopes, Karina M. Nogueira Napoles, Lorena Luiza Silva Neto Avelar, Lilian Aguiar Vieira, Luis Gustavo De Oliveira Cardo, Christianne F.V. Takeda, Glaydson A. Ponte, Fco Eduardo Aguiar Leitão, Ricardo De Souza Kuchenbecker, Rodrigo Pires Dos Santos, Erci Maria Onzi Siliprandi, Luiz Fernando Baqueiro Freitas, Ianick Souto Martins, Daiane Casi, Maria Angela Maretti Da Silva, Sergio Blecher, Margarete Villins, Reinaldo Salomao, Solange Regina Oliveira Castro, Daniela V. Da Silva Escudero, Mariana Andrade Oliveira Reis, Marcelo Mendonca, Valter Furlan, Antonio Claudio do Amaral Baruzzi, Tarquino Eristidesg Sanchez, Marina Moreira, Wania Vasconcelos de Freitas, Leonardo Passos de Souza, Velmira Angelova Velinova, Michael M. Petrov, Dimitar Georgiev Karadimov, Emil D. Kostadinov, Violeta Jivkova Dicheva, Chaohua Wang, Xiuqin Guo, Xihua Geng, Shufang Wang, Jinzhi Zhang, Ling Zhu, Shufang Zhuo, Chunli Guo, Tao Lili, Li Ruisheng, Liu Kun, Xuesong Yang, Li Yimin, Mao Pu, Li Changan, Yiang Shumei, Wu Kangxiong, Lin Meiyi, Guxiang Ye, Xu Ziqin, Suo Yao, Song Liqiang, Luis Marino Cañas Giraldo, Elsa Margarita Trujillo Ramirez, Paola Andrea Rios, Juan Carlos Torres Millan, Edwin Giovanny Chapeta Parada, Andres Eduardo Mindiola Rochel, Andres H. Corchuelo Martinez, Ana Marãa Perez Fernandez, Nayide Barahona Guzman, Alfredo Lagares Guzman, Marena Rodriguez Ferrer, Yazmin Leon Vega, Heidi Johanna Munoz, Germán Camacho Moreno, Sandra Liliana Romero Torres, Herlidia Taboada Hernandez, Ismael A. Valderrama MarquezClaudia Linares, Monica Espinosa Valencia, Lusayda Sanchez Corrales, Sandra Milena Bonilla, Jorge Ivan Marin Uribe, David Yepes Gomez, Javier Ospina Martinez, Luz Dary Burgos Florez, Johanna Osorio, Dagoberto Santofimio, Lorena Matta Cortes, Wilmer Villamil-Gomez, Gabriel Munoz Gutierrez, Adela Arguello Ruiz, Carlos Gonzalez Fuentes, Antonio Solano Chinchilla, Ivar Calvo Hernandez, Olber Chavarria Ugalde, Humberto Guanche Garcell, Clara Morales Perez, Selin Bardak, Sumru Ozkan, Nepomuceno Mejia, Adrian M. Puello Guerrero Glenny Mirabal, Margarita Delgado, Ramona Severino, Eliesel Lacerda, Gilda Tolari, María Marcela Bovera, Diego Barahona Pinto, Pedro Fernández González, Gasdali Santacruz, Nelly Alquinga, Celso Zaruma, Nelson Remache, Diego Morocho, Mario Arboleda, Mario Cadena Zapata, Maria Fernanda Garcia, Fabricio Picoita, Jorge Velez, Marcia Valle, Estuardo Salgado Yepez, Diego Morocho Tutillo, Ricardo Arteaga Mora, Andrea Peña Padilla, Mayra Chango, Karina Cabezas, Shirley Tenorio López, Ana Lucía Bonilla Escudero, Gladys Tatiana Sánchez, Hugo Alberto Gonzalez Flores, Islam Abdullorziz Ghazi, Mohamed Hassan, Ghada A. Ismail, Reham Hamed, Mona Mohiedden Abdel-Halim, May Abd El-Fattah, Doaa Abdel-Aziz, Zeinab Salah Seliem, Rasha Hamed Elsherif, Reham Ali Dewdar, Abeer Ahmed Mohmed, Lamiaa Abdel-Fatteh Ahmed, Lilian De Jesus Machuca, Concepcion Bran De Casares, Prokopis Kithreotis, Maria Daganou, Dimitrios Veldekis, Maria Kartsonaki, Achilleas Gikas, Marco Tulio Luque Torres, Denis Padgett, Doris Maribel Rivera, Namita Jaggi, Camilla Rodrigues, Bhagyesh Shah, Keyur Parikh, Jigar Patel, Riya Thakkar, Murali Chakravarthy, B.N. Gokul, R. Sukanya, Leema Pushparaj, Thejas Vini, Sukanya Rangaswamy, Saroj Kumar Patnaik, Vempati Venkateshwar, Biju John, Shamsher Dalal, Suneeta Sahu, Samir Sahu, Banambar Ray, Sudhiranjan Misra, Nisith Mohanty, Biraj Mohan Mishra, Prafulla Sahoo, Naresh Parmar, Sanghamitra Mishra, Basanta Kumar Pati, Santosh Singh, Bhabani Shankar Pati, Aparajita Panda, Swarna Banergee, Dipankar Padhihari, Soumya Samal, Karthikeya Varma, Velu Pandi Suresh Kumar, Ram Gopalakrishnan, Nagarajan Ramakrishnan, Babu Kuruvilla Abraham, Senthilkumar Rajagopal, Ramesh Venkatraman, Ashwin Kumar Mani, Dedeepiya Devaprasad, Lakshmi Ranganathan, Thara Francis, Kotturathu Mammen Cherain, Bala Ramachandran, Ravikumar Krupanandan, S. Muralidharan, Murali Karpagam, Baby Padmini, S. Saranya, Siva Kumar, Nirav Pandya, Rajesh Kakkar, Tenzin Zompa, Narinder Saini, Srinivas Samavedam, Ganshyam Jagathkar, Suhas Nirkhiwale, G.S. Gehlot, Shefali Bhattacharya, Sanjeev Sood, Suman Singh, Sanjeev Singh, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Susmita Basu, Anuradha Agarwal, Manoj Agarwal, Mohit Kharbanda, Sankar Sengupta, Anirban Karmakar, Debkishore Gupta, Ajoy Krishna Sarkar, Rimita Dey, Chandramouli Bhattacharya, Mammen Chandy, V.R. Ramanan, Aseem Mahajan, Manas Roy, Sanjay Bhattacharya, Saswati Sinha, Indranil Roy, Umesh Gupta, Sujoy Mukherjee, Mrinmoy Bej, Purnima Mukherjee, Sumana Baidya, Afzal Azim, Asmita Sagar Sakle, Jehangir Soli Sorabjee, Mrunalini Subhash Potdar, Vaibhavi R. Subhedar, F.E. Udwadia, Hena Francis, Arpita Dwivedy, Sheena Binu, Suvin Shetty, Pravin Kumar Nair, Devendra K. Khanna, Felcy Chacko, Seelas Blessymole, Preeti Rajeev Mehta, Tanu Singhal, Sweta Shah, Vatsal Kothari, Reshma Naik, Mayur Harshadrai Patel, Deepesh Gokulchand Aggarwal, Burhanuddin Qutbuddin Jawadwala, Niketa Kaul Pawar, Shoeb Nizamuddin Kardekar, Abizer Nuruddin Manked, S.N. Myatra, J.V. Divatia, R. Kelkar, S.K. Biswas, V. Raut, S. Sampat, Alka Thool, Anil Karlekar, Sumi Nandwani, Sudhir Gupta, Sanjay Singhal, Madhu Gupta, Purva Mathur, Subodh Kumar, Kavita Sandhu, Arnab Dasgupta, Abhijeet Raha, Padmalatha Raman, Ashoo Wadhera, Binesh Badyal, Sarika Juneja, Bikas Mishra, Sunil Sharma, Megha Mehrotra, Jayant Shelgaonkar, Vikram Padbidri, Rohini Dhawale, Sheena Mary Sibin, Dileep Mane, Hanamant Kashinath Sale, Mohammad Mukhit Abdul Gaffar Kazi, Supriya Chabukswar, Anju Mathew, Dipti Gaikwad, Amol Harshe, Gita Nadimpalli, Sunil Bhamare, Soniya Thorat, Omnarayan Sarda, Pattabhiramarao Nadimpalli, Angelina Mendonca, Sujata Malik, Asmita Kamble, Nilakshi Kumari, Sohini Arora, Nita Munshi, Deepa Ganesh Divekar, Maithili Satish Kavathekar, Anuja Kedar Kulkarni, Madhupriya Vijay Suryawanshi, Madhavi Latha Bommala, Anil Bilolikar, Kashmira Limaye Joshi, Charulata Pamnani, Harvinder Wasan, Sonali Khamkar, Leena Steephen, Arjun Rajalakshmi, Anzar Thair, Aisha Mubarak, Swathy Sathish, Suresh Kumar, H. Sunil, Sujith Sujith, null Dinesh, Nagamani Sen, Nitin Shinde, Masoud Alebouyeh, Somayeh Jahani-Sherafat, Mohammad Reza Zali, Mohammad Reza Sarbazi, Nahid Mansouri, Elahe Tajeddin, Maryam Razaghi, Simasadat Seyedjavadi, Marjan Rashidan, Mansoor Masjedi, Behzad Maghsudi, Golnar Sabetian, Anahita Sanaei, Atefeh Yousefipour, Abdullah Mufareh Assiri, Elaine Mari Furukawa-Cinquini, Areej Dhafer Alshehri, Alysia Faye Giani, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Ibrahim A.M. Al-Zaydani Asiri, Yassir Khidir Mohammed, Mohammed Abdullah Al Raey, Ali Omer Abdul Aziz, Saeed Ali Al Darani, Misbah Rehman Aziz, Roaa Hasan Basri, Duaa Khalil Al-Awadi, Syed Zahid Bukhari, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Apsia Musa Molano, Hessa Abdullah Al Enizy, Celia Flores Baldonado, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Avigail M. Tan, Sonia Joseph, Deepa Sasidharan Nair, Nabeela Abdullah Al-Abdullah, Grace Sindayen, Annalyn Amor Malificio, Diaa Abdullah Mohammed, Hanan Mesfer Al Ghamdi, Ameurfina Curioso Silo, Marianina Brenda V. Valisto, Nektarios Foteinakis, Sameeh Salem Ghazal, Mercy V. Joseph, Ahmed Hakawi, Antigona Hasani, Ismet Jusufi, Gazmend Spahija, Nehat Baftiu, Agreta Gecaj-Gashi, Nasser Yehia Aly, Mohammad El-Dossoky Noweir, Suga Thomas Varghese, Ruby Jose Ramapurath, Amna Mostafa Mohamed, Sneha Mary George, Anu Kurian, Amani Fouad Sayed, Mona Foda Salama, Abeer Aly Omar, Flavie Maria Rebello, Dennis Malungcot Narciso, Nada Kara Zahreddine, Zeina Kanafani, Tala Kardas, Bassel Molaeb, Lamia Jurdi, Anwar Al Souheil, Mohamad Ftouni, Hasan Ayash, Tahsine Mahfouz, Tomas Kondratas, Dovile Grinkeviciute, Rimantas Kevalas, Greta Gailiene, Algirdas Dagys, Milena Petrovska, Katja Popovska, Zaneta Bogoevska-Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Tanja Anguseva, Wan Nurbayah Wan Yusoff, Anis Shiham Zainal Abidin, Chin Seng Gan, Hasimah Zainol, Vineya Rai, Wong Kang Kwong, Mohd Shahnaz Hasan, Sasheela Sri La Sri Ponnampala, Jeyaganesh Veerakumaran, Ojan Assadian, Doan Mai Phuong, Nguyen Gia Binh, Kerinjeet Kaur, Joelene Lim, Lian-Huat Tan, Jegathesan Manikavasagam, Yuet-Meng Cheong, Hilario Coronado Magaña, Julio Cesar Mijangos Méndez, Federico Corona Jiménez, Sergio Esparza-Ahumada, Rayo Morfin-Otero, Eduardo Rodriguez-Noriega, Susana Gutierrez-Martinez, Hector Raul Perez-Gomez, Gerardo León-Garnica, Christian Mendoza-Mujica, Martha Cecilia Culebro Burguet, Jorge Horacio Portillo-Gallo, Fernando Aguilera Almazán, Gaspar Iglesias Miramontes, Maria del Rosario Vázquez Olivas, Lucio Alberto Aguilar Angel, Marisol Sanchez Vargas, Angel Orlando Flores Alvarado, Roberto Carlos Mares Morales, Luis Carlos Fernandez Alvarez, Hector Armando Rincon Leon, Karla Reyna Navarro Fuentes, Yuri Mariela Perez Hernandez, Gabriela Martinez Falcon, Angel Gonzalez Vargas, Marco A. Trujillo Juarez, Antonio Martinez Mulia, Paulina Alma Ulloa Camacho, Martha Y. Martinez-Marroquin, Marco Montell Garcia, Araceli Martinez Martinez, Elena Leon Sanchez, Guadalupe Gomez Flores, Marisela del Rocío González Martínez, Jesús Alfonso Galindo Olmeda, Georgina Olivarez, Enrique Barbachano Rodriguez, María Magdalena Gutierrez Castillo, María Guadalupe Villa González, Isaura Beatriz Sauceda Castañeda, Jaime Martínez Rodriguez, Otgon Baatar, Byambadorj Batkhuu, Kabiri Meryem, Barkat Amina, Rédouane Abouqal, Amine Ali Zeggwagh, Tarek Dendane, Khalid Abidi, Naoufel Madani, Syed Faisal Mahmood, Badaruddin A. Memon, Gul Hassan Bhutto, Nadeem Paul, Azra Parveen, Aun Raza, Amjad Mahboob, Summiya Nizamuddin, Faisal Sultan, Hammad Nazeer, Ashraf Ali Khan, Arifa Hafeez, Lydia Lara, Trudell Mapp, Balkys Alvarez, Magda Ivonne Rojas-Bonilla, Elizabeth Castano, Daisy A. De Moros, Roberto Espinoza Atarama, Maria Elena Calisto Pazos, Alfredo Paucar, Marlene Tasayco Ramos, Jenny Jurado, Dafne Moreno, Marãa E. Cruz Saldarriaga, Eliza Ramirez, Carlos Enrique La Hoz Vergara, Walter Enrique Prudencio Leon, Luis Isidro Castillo Bravo, Katya Fernanda Aibar Yaranga, Janet E. Pichilingue Chagray, Vanessa A. Marquez Mondalgo, Socorro Torres Zegarra, Nazario Silva Astete, Francisco Campos Guevara, Javier Soto Pastrana, Carlos F. Linares Calderon, Manuel Jesus Mayorga Espichan, Luis Martin Santivanez Monge, Maria V. Changano Rodriguez, Zoila Rosa Diaz Tavera, Fernando Martin Ramirez Wong, Selene Manga Chavez, Teodora Atencio-Espinoza, Victoria D. Villanueva, Maria Teresa Blanco-Abuy, Arnefelina S. Tamayo, Lailane D. Bergosa, Cristina Mari Jean P. Llames, Marilou F. Trajano, Suzette A. Bunsay, Jessica C. Amor, Regina Berba, Maria Carmen Sg Buenaflor, Ever Labro, Myrna T. Mendoza, Ofelia P. Javellana, Lilibeth G. Salvio, Rhoda Gay Rayco, Vanessa Bermudez, Andrzej Kubler, Marzena Zielinska, Magdalena Kosmider-Zurawska, Barbara Barteczko-Grajek, Ewa Szewczyk, Barbara Dragan, Malgorzata Anna Mikaszewska-Sokolewicz, Tomasz Lazowski, Elsie Cancel, Monica Sorina Licker, Liliana Alina Dragomirescu, Victor Dumitrascu, Dorel Sandesc, Ovidiu Bedreag, Marius Papurica, Delia Muntean, Igor Kotkov, Vladimir Kretov, Vladimir Shalapuda, Alexander Molkov, Sergey Puzanov, Ivan Utkin, Alexander Tchekulaev, Valentina Tulupova, Ljubica Nikolic, Goran Ristic, Jelena Eremija, Jelena Kojovic, Dragana Lekic, Sladjana Vasiljevic, Anna Lesnakova, Alzbeta Marcekova, Katarina Furova, May Osman Gamar Elanbya, Malik Abdo Ali, Shobhana Kumari Kadankunnel, Suwara Somabutr, Rungratchanee Pimathai, Suthinee Wanitanukool, Montri Luxsuwong, Namphon Supa, Pornpheth Prasan, Visanu Thamlikitkul, Silom Jamulitrat, Nonglak Suwalak, Parichart Phainuphong, Bouziri Asma, Borgi Aida, Bel Hadj Sarra, Khaldi Ammar, Gunay Tuncer Ertem, Cemal Bulut, Cigdem Ataman Hatipoglu, Fatma Sebnem Erdinc, Ali Pekcan Demiroz, Menekse Ozcelik, Basak Ceyda Meco, Mehmet Oral, Necmettin Unal, Cigdem Yildirim Guclu, Tanıl Kendirli, Erdal İnce, Ergin Çiftçi, Ayhan Yaman, Çağlar Ödek, Adem Karbuz, Bilge Aldemir Kocabaş, Nilgün Altın, Salih Cesur, Begum Atasay, Omer Erdeve, Hasan Akduman, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Atila Kilic, Saadet Arsan, Dilek Arman, Serhat Unal, Yasemin Gelebek, Humeyra Zengin, Suha Sen, Hatice Cabadak, Ayse Erbay, Ata Nevzat Yalcin, Ozge Turhan, Melike Cengiz, Oguz Dursun, Perihan Gunasan, Sehnaz Kaya, Atilla Ramazanoglu, Cemal Ustun, Aliye Yasayacak, Hayrettin Akdeniz, Fatma Sirmatel, Ali Metin Otkun, Suzan Sacar, Alper Sener, Huseyn Turgut, Hulya Sungurtekin, Dogaç Ugurcan, Ceyda Necan, Cansu Yilmaz, Davut Ozdemir, Mehmet Faruk Geyik, Nevin Ince, Ayse Danis, Selvi Yener Erdogan, Nurettin Erben, Gaye Usluer, Ilhan Ozgunes, Cengiz Uzun, Oral Oncul, Levent Gorenek, Hakan Erdem, Orhan Baylan, Asu Ozgultekin, Asuman Inan, Sibel Bolukcu, Gunes Senol, Halil Ozdemir, Zeynel Gokmen, Sonay Incesoy Ozdemir, Ali Kaya, Gulden Ersoz, Necdet Kuyucu, Sevim Karacorlu, Zeynep Kaya, Ertugrul Guclu, Gulsume Kaya, Oguz Karabay, Saban Esen, Canan Aygun, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Mustafa Sunbul, Aynur Engin, Mehmet Bakir, Nazif Elaldi, Iftihar Koksal, Dincer Yildizdas, Ozden Ozgur Horoz, Ayşe Willke, Meliha Meriç Koç, Emel Azak, Naheed Elahi, Philip Annamma, Ashraf El Houfi, Maria Catalina Pirez Garcia, Hector Vidal, Fernando Perez, Gabriel D. Empaire, Yvis Ruiz, Dulce Hernandez, Dayana Aponte, Evelyn Salinas, Claudia Diaz, María Eugenia Guzmán Siritt, Zenaida Durán Gil De Añez, Luis Montes Bravo, Nelva Orozco, Eugenia Mejías, Nguyen Viet Hung, Nguyen Quoc Anh, Ngo Quy Chau, Truong Anh Thu, Le Thi Diem Tuyet, Dang Thi Van Trang, Vo Thi Hong Thoa, Nguyen Phuc Tien, Le Thi Anh Thu, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Dinh Pham Phuong Anh, Ondokuz Mayıs Üniversitesi, KILIÇ, ATİLA, and MERİÇ KOÇ, MELİHA

Subjects
Imipenem, medicine.medical_specialty, Pediatrics, Low income countries, Asia, Epidemiology, Klebsiella pneumoniae, Health care-associated infection, Antibiotic resistance, Catheter-associated urinary tract infection, Ceftazidime, Network, Bloodstream infection, Developing countries, Nosocomial infection, Intensive care, medicine, Ventilator-associated pneumonia, Humans, Hospital infection, Prospective Studies, Urinary tract infection, Cross Infection, Infection Control, biology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Nosocomial infection control, biology.organism_classification, Device-associated infection, United States, Europe, Pneumonia, Intensive Care Units, Infectious Diseases, Latin America, Amikacin, Emergency medicine, Africa, Limited resources countries, Central line-associated bloodstream infections, Centers for Disease Control and Prevention, U.S, business, medicine.drug
Abstract

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2014

11. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009

Author

Victor D, Rosenthal, Hu, Bijie, Dennis G, Maki, Yatin, Mehta, Anucha, Apisarnthanarak, Eduardo A, Medeiros, Hakan, Leblebicioglu, Dale, Fisher, Carlos, Álvarez-Moreno, Ilham Abu, Khader, Marisela, Del Rocío González Martínez, Luis E, Cuellar, Josephine Anne, Navoa-Ng, Rédouane, Abouqal, Humberto, Guanche Garcell, Zan, Mitrev, María Catalina, Pirez García, Asma, Hamdi, Lourdes, Dueñas, Elsie, Cancel, Vaidotas, Gurskis, Ossama, Rasslan, Altaf, Ahmed, Souha S, Kanj, Olber Chavarría, Ugalde, Trudell, Mapp, Lul, Raka, Cheong, Yuet Meng, Le Thi Anh, Thu, Sameeh, Ghazal, Achilleas, Gikas, Leonardo Pazmiño, Narváez, Nepomuceno, Mejía, Nassya, Hadjieva, May Osman, Gamar Elanbya, María Eugenia, Guzmán Siritt, Kushlani, Jayatilleke, Roswitha, Wolfram, OMÜ, Rosenthal, VD, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, and Güçlü, Ertuğrul

Subjects
Male, Imipenem, Epidemiology, Antibiotic resistance, International Cooperation, Ceftazidime, Network, intensive care unit, law.invention, Nosocomial infection, law, Prevalence, Infection control, Prospective Studies, ceftazidime, Child, Aged, 80 and over, catheter infection, Cross Infection, Urinary tract infection, Health Policy, Ventilator-associated pneumonia, article, Bacterial Infections, Middle Aged, Intensive care unit, infection control, Device-associated infection, Low-income countries, Europe, Intensive Care Units, Klebsiella pneumoniae, Infectious Diseases, Child, Preschool, Pseudomonas aeruginosa, Central line-associated bloodstream infection, Limited-resources countries, Female, disease surveillance, medicine.drug, hospitalization, prospective study, Adult, meticillin, medicine.medical_specialty, Staphylococcus aureus, Asia, Adolescent, Health care-associated infection, Catheter-associated urinary tract infection, bloodstream infection, Bloodstream infection, South and Central America, Developing countries, Young Adult, Internal medicine, Intensive care, medicine, Escherichia coli, Humans, Hospital infection, human, Intensive care medicine, Aged, nonhuman, Bacteria, business.industry, bacterium isolate, Infant, Newborn, Public Health, Environmental and Occupational Health, developing country, Infant, medicine.disease, Nosocomial infection control, mortality, hospital bed, Latin America, Africa, ventilator associated pneumonia, business
Abstract

Medeiros, Eduardo A/0000-0002-6205-259X; Garcell, Humberto Guanche/0000-0001-7279-0062; Leblebicioglu, Hakan/0000-0002-6033-8543; Dikmen, Yalim/0000-0002-3122-5099; Abouqal, Redouane/0000-0002-6117-4341; Kendirli, Tanil/0000-0001-9458-2803; Tsioutis, Constantinos/0000-0002-7865-8529; Yalcin, Ata Nevzat/0000-0002-7243-7354; Abouqal, Redouane/0000-0002-6117-4341; Acar, Ali/0000-0003-2008-5112; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Ozdemir, Halil/0000-0002-7318-1688; Satti, Asim/0000-0001-8432-6101; Barahona G., Nayide/0000-0003-3559-6900; Gikas, Achilleas/0000-0002-8455-9631; Mitrev, Zan/0000-0001-7859-8821; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Kanj, Souha/0000-0001-6413-3396; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454 WOS: 000304378300003 PubMed: 21908073 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 (C) 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2012
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12. Findings of the International Nosocomial Infection Control Consortium (INICC), Part II: Impact of a Multidimensional Strategy to Reduce Ventilator-Associated Pneumonia in Neonatal Intensive Care Units in 10 Developing Countries

Author

Regina Berba, Josephine Anne Navoa-Ng, Victor D. Rosenthal, Teodora Atencio-Espinoza, M. Pawar, Nejla Ben-Jaballah, Gülden Ersöz, Amina Barkat, Martha Sobreyra-Oropeza, Tanu Singhal, Lourdes Dueñas, Canan Aygün, Marena Rodríguez-Ferrer, Davut Ozdemir, María Eugenia Rodríguez-Calderón, and Ondokuz Mayıs Üniversitesi

Subjects
Microbiology (medical), Program evaluation, medicine.medical_specialty, Epidemiology, Psychological intervention, Developing country, Cohort Studies, Intensive Care Units, Neonatal, Intensive care, Humans, Infection control, Medicine, Prospective Studies, Intensive care medicine, Developing Countries, Cross Infection, Infection Control, business.industry, Infant, Newborn, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, medicine.disease, Nosocomial infection control, Infectious Diseases, Population Surveillance, Emergency medicine, business, Program Evaluation, Cohort study
Abstract

Design.Before-after prospective surveillance study to assess the efficacy of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control program to reduce the rate of occurrence of ventilator-associated pneumonia (VAP).Setting.Neonatal intensive care units (NICUs) of INICC member hospitals from 15 cities in the following 10 developing countries: Argentina, Colombia, El Salvador, India, Mexico, Morocco, Peru, Philippines, Tunisia, and Turkey.Patients.NICU inpatients.Methods.VAP rates were determined during a first period of active surveillance without the implementation of the multidimensional approach (phase 1) to be then compared with VAP rates after implementation of the INICC multidimensional infection control program (phase 2), which included the following practices: a bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices. This study was conducted by infection control professionals who applied National Health Safety Network (NHSN) definitions for healthcare-associated infections and INICC surveillance methodology.Results.During phase 1, we recorded 3,153 mechanical ventilation (MV)–days, and during phase 2, after the implementation of the bundle of interventions, we recorded 15,981 MV-days. The VAP rate was 17.8 cases per 1,000 MV-days during phase 1 and 12.0 cases per 1,000 MV-days during phase 2 (relative risk, 0.67 [95% confidence interval, 0.50–0.91]; P = .001 ), indicating a 33% reduction in VAP rate.Conclusions.Our results demonstrate that an implementation of the INICC multidimensional infection control program was associated with a significant reduction in VAP rate in NICUs in developing countries.

Published
2012
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13. Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings

Author

Bala Ramachandran, Antonio Menco, Lilian de Jesus Machuca, Eylul Gumus, Sevim Keskin, Ata Nevzat Yalcin, Kavitha Radhakrishnan, Ana Concepción Bran de Casares, María Corazon V Tolentino, Necdet Kuyucu, Josephine Anne Navoa-Ng, Victor D. Rosenthal, Victoria D. Villanueva, Oguz Dursun, Patrick Arrieta, Ali Kaya, Carlos Alvarez-Moreno, Lourdes Dueñas, Gülden Ersöz, Özge Turhan, Sanjeev Singh, and Wilmer E. Villamil-Gómez

Subjects
Male, medicine.medical_specialty, Epidemiology, Psychological intervention, Hospital-acquired pneumonia, Intensive Care Units, Pediatric, Intensive care, medicine, Prevalence, Infection control, Humans, Intensive care medicine, Developing Countries, Infection Control, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Ventilator-associated pneumonia, Infant, Pneumonia, Ventilator-Associated, Nosocomial infection control, medicine.disease, respiratory tract diseases, Pneumonia, Infectious Diseases, Relative risk, Child, Preschool, Female, business
Abstract

Background Ventilator-associated pneumonia (VAP) is one of the most common health care–associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. Methods This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care—associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. Results During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate. Conclusions Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.

Published
2011

14. Socioeconomic impact on device-associated infections in limited-resource neonatal intensive care units: findings of the INICC

Author

C. Yuet-Meng, Rosana Richtmann, Victor D. Rosenthal, M. Pawar, Nejla Ben Jaballah, Amina Barkat, Lourdes Dueñas, P. Lynch, Teodora Atencio-Espinoza, W. R. Jarvis, Canan Aygün, Martha Sobreyra-Oropeza, Inicc members, Josephine Anne Navoa-Ng, Wilmer E. Villamil-Gómez, Anucha Apisarnthanarak, Ilham Abu Khader, Nepomuceno Mejia, and Ondokuz Mayıs Üniversitesi

Subjects
Microbiology (medical), medicine.medical_specialty, Catheterization, Central Venous, Ventilator associated pneumonia, health care facilities, manpower, and services, law.invention, Hospitals, Private, law, Intensive care, Intensive Care Units, Neonatal, medicine, Humans, Intensive care unit, Prospective Studies, Intensive care medicine, Hospitals, Teaching, Socioeconomic status, Developing Countries, Catheter-associated urinary tract infection, Cross Infection, Ventilators, Mechanical, business.industry, Hospitals, Public, International nosocomial infection control consortium, Ventilator-associated pneumonia, Infant, Newborn, Pneumonia, Ventilator-Associated, General Medicine, medicine.disease, Catheter associated urinary tract infection, Health care acquired infection, Infectious Diseases, Hospital treatment, Socioeconomic Factors, Catheter-Related Infections, Equipment Contamination, Central line associated blood stream infection, business, Limited resources
Abstract

WOS: 000296843100008 PubMed: 21732120 Purpose To evaluate the impact of country socioeconomic status and hospital type on device-associated healthcare-associated infections (DA-HAIs) in neonatal intensive care units (NICUs). Methods Data were collected on DA-HAIs from September 2003 to February 2010 on 13,251 patients in 30 NICUs in 15 countries. DA-HAIs were defined using criteria formulated by the Centers for Disease Control and Prevention. Country socioeconomic status was defined using World Bank criteria. Results Central-line-associated bloodstream infection (CLA-BSI) rates in NICU patients were significantly lower in private than academic hospitals (10.8 vs. 14.3 CLA-BSI per 1,000 catheter-days; p < 0.03), but not different in public and academic hospitals (14.6 vs. 14.3 CLA-BSI per 1,000 catheter-days; p = 0.86). NICU patient CLA-BSI rates were significantly higher in low-income countries than in lower-middle-income countries or upper-middle-income countries [37.0 vs. 11.9 (p < 0.02) vs. 17.6 (p < 0.05) CLA-BSIs per 1,000 catheter-days, respectively]. Ventilator-associated-pneumonia (VAP) rates in NICU patients were significantly higher in academic hospitals than in private or public hospitals [13.2 vs. 2.4 (p < 0.001) vs. 4.9 (p < 0.001) VAPs per 1,000 ventilator days, respectively]. Lower-middle-income countries had significantly higher VAP rates than low-income countries (11.8 vs. 3.8 per 1,000 ventilator-days; p < 0.001), but VAP rates were not different in low-income countries and upper-middle-income countries (3.8 vs. 6.7 per 1,000 ventilator-days; p = 0.57). When examined by hospital type, overall crude mortality for NICU patients without DA-HAIs was significantly higher in academic and public hospitals than in private hospitals (5.8 vs. 12.5%; p < 0.001). In contrast, NICU patient mortality among those with DA-HAIs was not different regardless of hospital type or country socioeconomic level. Conclusions Hospital type and country socioeconomic level influence DA-HAI rates and overall mortality in developing countries.

Published
2010

15. Device-associated infections rates in pediatrics and neonatal intensive care units in El Salvador: findings of the INICC

Author

Lourdes Dueñas, Ana Bran de Casares, Lilian de Jesus Machuca, and Victor D. Rosenthal

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, health care facilities, manpower, and services, media_common.quotation_subject, Intensive Care Units, Pediatric, Microbiology, law.invention, Cohort Studies, law, Hygiene, Virology, Intensive care, Health care, medicine, El Salvador, Infection control, Humans, Prospective Studies, Prospective cohort study, Child, media_common, Pediatric intensive care unit, Cross Infection, business.industry, Infant, Newborn, Infant, Pneumonia, Ventilator-Associated, General Medicine, Length of Stay, Intensive care unit, Survival Analysis, Infectious Diseases, Catheter-Related Infections, Child, Preschool, Parasitology, Female, Guideline Adherence, business, Cohort study, Hand Disinfection
Abstract

Introduction: This study aimed to determine the rate of device-associated, health care-associated infection (DA-HAI), the excess in length of stay, the mortality, and the hand hygiene compliance in a pediatric intensive care unit (PICU) and a neonatal ICU (NICU) in a hospital member of the International Infection Control Consortium (INICC) in El Salvador. Methodology: A prospective cohort, active DA-HAI surveillance study was conducted on patients admitted in the pediatric and neonatal ICUs from January 2007 to November 2009. The protocol and methodology implemented were developed by INICC. Data were collected in the participating ICUs, and analyzed at INICC headquarters by proprietary software. DA-HAI rates were recorded by applying the definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network. Results: Of 1,145 patients hospitalized in the PICU for 9,517 days, 177 acquired DA-HAIs (overall rate 15.5%), and 18.6 DA-HAIs per 1,000 ICU-days. Furthermore, 1,270 patients hospitalized in the NICU for 30,663 days acquired 302 DA-HAIs (overall rate 23.8%), and 9.8 DA-HAIs per 1,000 ICU-days. The central line-associated bloodstream infection (CLA-BSI) rates in the NICU and PICU were 9.9 and 10.0 per 1,000 catheter-days respectively. The ventilator-associated pneumonia (VAP) rate was 16.1 per 1,000 ventilator-days in the NICU and 12.1 in the PICU.The catheter-associated urinary tract infection (CAUTI) rate was 5.8 per 1,000 catheter-days in the PICU. Conclusions: DA-HAI rates in the PICU and NICU of our hospital were higher than international standards; infection control programs including surveillance and antibiotic policies must be a priority in El Salvador.

Published
2010

16. International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009

Author

Victor D, Rosenthal, Dennis G, Maki, Silom, Jamulitrat, Eduardo A, Medeiros, Subhash Kumar, Todi, David Yepes, Gomez, Hakan, Leblebicioglu, Ilham, Abu Khader, María Guadalupe, Miranda Novales, Regina, Berba, Fernando Martín, Ramírez Wong, Amina, Barkat, Osiel Requejo, Pino, Lourdes, Dueñas, Zan, Mitrev, Hu, Bijie, Vaidotas, Gurskis, S S, Kanj, Trudell, Mapp, Rosalía Fernández, Hidalgo, Nejla, Ben Jaballah, Lul, Raka, Achilleas, Gikas, Altaf, Ahmed, Le Thi Anh, Thu, María Eugenia, Guzmán Siritt, Pham Hông, Zruong, and OMÜ

Subjects
antibiotic resistance, Epidemiology, Infection control, health care-associated infection, Antibacterial agent, Cross Infection, biology, Health Policy, Incidence, Ventilator-associated pneumonia, central line-associated bloodstream infections, Bacterial Infections, INICC, Acinetobacter baumannii, Europe, Intensive Care Units, Infectious Diseases, nosocomial infection, low income countries, medicine.drug, Adult, medicine.medical_specialty, Asia, bloodstream infection, ventilator-associated pneumonia, Young Adult, Internal medicine, Intensive care, catheter-associated urinary tract infection, Drug Resistance, Bacterial, medicine, Humans, Hospital infection, Intensive care medicine, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, Infant, International Nosocomial Infection Consortium, developing countries, medicine.disease, Nosocomial infection control, biology.organism_classification, device-associated infection, United States, Latin America, Bacteremia, network, Africa, business, urinary tract infection, limited resources countries, Piperacillin
Abstract

Leblebicioglu, Hakan/0000-0002-6033-8543; Acar, Ali/0000-0003-2008-5112; Yalcin, Ata Nevzat/0000-0002-7243-7354; Tsioutis, Constantinos/0000-0002-7865-8529; Medeiros, Eduardo A/0000-0002-6205-259X; Dikmen, Yalim/0000-0002-3122-5099; Kuchenbecker, Ricardo/0000-0002-4707-3683; Kanj, Souha/0000-0001-6413-3396; Unal, Necmettin/0000-0002-9440-7893; Mitrev, Zan/0000-0001-7859-8821; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Miranda Novales, Maria Guadalupe/0000-0003-3262-2608; Gikas, Achilleas/0000-0002-8455-9631; Barahona G., Nayide/0000-0003-3559-6900 WOS: 000274859500003 PubMed: 20176284 We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).

Published
2009

17. International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008

Author

Victor D, Rosenthal, Dennis G, Maki, Ajita, Mehta, Carlos, Alvarez-Moreno, Hakan, Leblebicioglu, Francisco, Higuera, Luis E, Cuellar, Naoufel, Madani, Zan, Mitrev, Lourdes, Dueñas, Josephine Anne, Navoa-Ng, Humberto Guanche, Garcell, Lul, Raka, Rosalía Fernández, Hidalgo, Eduardo A, Medeiros, Souha S, Kanj, Salisu, Abubakar, Patricio, Nercelles, Ricardo Diez, Pratesi, Gonzalo, De León, and OMÜ

Subjects
medicine.medical_specialty, Pediatrics, Asia, Epidemiology, International Cooperation, Drug resistance, medicine.disease_cause, Intensive care, Drug Resistance, Bacterial, medicine, Prevalence, Humans, Gram-Positive Bacterial Infections, Cross Infection, Organizations, Pseudomonas aeruginosa, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Nosocomial infection control, medicine.disease, Europe, Pneumonia, Intensive Care Units, Infectious Diseases, Latin America, Staphylococcus aureus, Emergency medicine, Africa, Ceftriaxone, Enterobacter species, business, Gram-Negative Bacterial Infections, medicine.drug
Abstract

Medeiros, Eduardo A/0000-0002-6205-259X; Yalcin, Ata Nevzat/0000-0002-7243-7354; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Dikmen, Yalim/0000-0002-3122-5099; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; , Salisu/0000-0003-4510-1430; Unal, Necmettin/0000-0002-9440-7893; Chatterjee, Sharmila/0000-0001-5905-1089; Graves, Nicholas/0000-0002-5559-3267; Chatterjee, Sharmila/0000-0002-3890-8386; Mitrev, Zan/0000-0001-7859-8821; Kanj, Souha/0000-0001-6413-3396 WOS: 000260963300002 PubMed: 18992646 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from 2002 through 2007 in 98 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance System (NNIS) definitions for device-associated health care-associated infection, we collected prospective data from 43,114 patients hospitalized in the Consortium's hospital ICUs for an aggregate of 272,279 days. Although device utilization in the INICC ICUs was remarkably similar to that reported from US ICUs in the CDC's National Healthcare Safety Network, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infections (CLABs) in the INICC ICUs, 9.2 per 1000 CL-days, is nearly 3-fold higher than the 2.4-5.3 per 1000 CL-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia was also far higher, 19.5 vs 1.1-3.6 per 1000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 6.5 versus 3.4-5.2 per 1000 catheter-days. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (80.8% vs 48.1 %), Enterobacter species to ceftriaxone (50.8% vs 17.8%), and Pseudomonas aeruginosa to fluoroquinolones (52.4% vs 29.1 %) were also Far higher in the Consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 14.3 % (CLABs) to 27.5% (ventilator-associated pneumonia). (Am J Infect Control 2008:36:627-37.)

Published
2008

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