Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

被引：5

作者：

Rosenthal, Victor Daniel ^{[1
,2
]}

Jin, Zhilin ^{[1
]}

Valderrama-Beltran, Sandra Liliana ^{[3
]}

Gualtero, Sandra Milena ^{[3
]}

Linares, Claudia Yaneth ^{[3
]}

Aguirre-Avalos, Guadalupe ^{[4
]}

Mijangos-Mendez, Julio Cesar ^{[4
]}

Ibarra-Estrada, Miguel Angel ^{[4
]}

Jimenez-Alvarez, Luisa Fernanda ^{[5
]}

Reyes, Lidia Patricia ^{[5
]}

Alvarez-Moreno, Carlos Arturo ^{[5
]}

Zuniga-Chavarria, Maria Adelia ^{[6
]}

Quesada-Mora, Ana Marcela ^{[6
]}

Gomez, Katherine ^{[7
]}

Alarcon, Johana ^{[7
]}

Millan-Onate, Jose ^{[7
]}

Aguilar-de-Moros, Daisy ^{[8
]}

Castano-Guerrero, Elizabeth ^{[8
]}

Cordoba, Judith ^{[8
]}

Sassoe-Gonzalez, Alejandro ^{[9
]}

Millan-Castillo, Claudia Marisol ^{[9
]}

Leyva-Xotlanihua, Lissette ^{[9
]}

Aguilar-Moreno, Lina Alejandra ^{[10
]}

Bravo-Ojeda, Juan Sebastian ^{[10
]}

Gutierrez-Tobar, Ivan Felipe ^{[10
]}

Aleman-Bocanegra, Mary Cruz ^{[11
]}

Echazarreta-Martinez, Clara Veronica ^{[11
]}

Flores-Sanchez, Belinda Mireya ^{[11
]}

Cano-Medina, Yuliana Andrea ^{[12
]}

Chapeta-Parada, Edwin Giovannny ^{[12
]}

Gonzalez-Nino, Rafael Antonio ^{[12
]}

Villegas-Mota, Maria Isabel ^{[13
]}

Montoya-Malvaez, Mildred ^{[13
]}

Cortes-Vazquez, Miguel Angel ^{[13
]}

Medeiros, Eduardo Alexandrino ^{[14
]}

Fram, Dayana ^{[14
]}

Vieira-Escudero, Daniela ^{[14
]}

Duenas, Lourdes ^{[15
]}

Carreazo, Nilton Yhuri ^{[16
]}

Salgado, Estuardo ^{[17
]}

Yin, Ruijie ^{[1
]}

机构：

[1] Univ Miami, Miller Sch Med, Dept Publ Hlth Sci, 1120 NW 14th St, Floor 9, Off 912, Miami, FL 33136 USA

[2] INICC Fdn, Int Nosocomial Infect Control Consortium, Miami, FL USA

[3] Pontificia Univ Javeriana, Hosp Univ San Ignacio, Bogota, Colombia

[4] Univ Guadalajara, Ctr Univ Ciencias Salud, Hosp Civil Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico

[5] Clin Univ Colombia, Bogota, Colombia

[6] Hosp Clin Bibl, San Jose, Costa Rica

[7] Clin Sebastian Belalcazar, Cali, Colombia

[8] Hosp Nino Dr Jose Renan Esquivel, Panama City, Panama

[9] Hosp Reg Alta Especial Ixtapaluca, Ixtapaluca, Mexico

[10] Clin Infantil Santa Maria Lago, Bogota, Colombia

[11] Hosp San Jose TecSalud, Monterrey, Nuevo Leon, Mexico

[12] Inst Corazon Bucaramanga, Sede Bogota, Bogota, Colombia

[13] Inst Nacl Perinatol, Mexico City, DF, Mexico

[14] Univ Fed Sao Paulo, Hosp Sao Paulo, Sao Paulo, Brazil

[15] Hosp Nacl Ninos Benjamin Bloom, San Salvador, El Salvador

[16] Univ Peruana Ciencias Aplicadas, Hosp Emergencias Pediat, Lima, Peru

[17] Hosp Especialidades Ctr Med La Raza, Alianza Del Ecuador, Ecuador

来源：

AMERICAN JOURNAL OF INFECTION CONTROL | 2023年 / 51卷 / 10期

关键词：

Intensive care units; INICC; Latin America; Bloodstream infection; Risk factors; PICC; INTENSIVE-CARE UNITS; CONTROL CONSORTIUM INICC; CENTRAL VENOUS CATHETERS; MULTIDIMENSIONAL APPROACH; RATES; HOSPITALS; IMPACT; MORTALITY; ADULT; STRATEGY;

D O I：

10.1016/j.ajic.2023.03.006

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.Methods: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).Results: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.Conclusions: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.(c) 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

引用

页码：1114 / 1119

页数：6

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