Impact of a multidimensional infection control approach on catheter-associated urinary tract infection rates in adult intensive care units in 10 cities of Turkey: International Nosocomial Infection Control Consortium findings (INICC)

被引：49

作者：

Leblebicioglu, Hakan ^{[1
]}

Ersoz, Gulden ^{[2
]}

Daniel Rosenthal, Victor ^{[3
]}

Nevzat-Yalcin, Ata ^{[4
]}

Akan, Ozay Arikan ^{[5
]}

Sirmatel, Fatma ^{[6
]}

Turgut, Huseyin ^{[7
]}

Ozdemir, Davut ^{[8
]}

Alp, Emine ^{[9
]}

Uzun, Cengiz ^{[10
]}

Ulusoy, Sercan ^{[11
]}

Esen, Saban ^{[1
]}

Ulger, Fatma ^{[1
]}

Dilek, Ahmet ^{[1
]}

Yilmaz, Hava ^{[1
]}

Kaya, Ali ^{[2
]}

Kuyucu, Necdet ^{[2
]}

Turhan, Ozge ^{[4
]}

Gunay, Nurgul ^{[4
]}

Gumus, Eylul ^{[4
]}

Dursun, Oguz ^{[4
]}

Tulunay, Melek ^{[5
]}

Oral, Mehmet ^{[5
]}

Unal, Necmettin ^{[5
]}

Cengiz, Mustafa ^{[12
]}

Yilmaz, Leyla ^{[12
]}

Sacar, Suzan ^{[7
]}

Sungurtekin, Hulya ^{[7
]}

Ugurcan, Dogac ^{[7
]}

Geyik, Mehmet Faruk ^{[8
]}

Sahin, Ahmet ^{[8
]}

Erdogan, Selvi ^{[8
]}

Aygen, Bilgehan ^{[9
]}

Arda, Bilgin ^{[11
]}

Bacakoglu, Feza ^{[11
]}

机构：

[1] Ondokuz Mayis Univ, Sch Med, Samsun, Turkey

[2] Mersin Univ, Fac Med, Mersin, Turkey

[3] Int Nosocomial Infect Control Consortium, Buenos Aires, DF, Argentina

[4] Akdeniz Univ, TR-07058 Antalya, Turkey

[5] Ankara Univ, Sch Med, Ibni Sina Hosp, TR-06100 Ankara, Turkey

[6] Abant Izzet Baysal Univ, Bolu, Turkey

[7] Pamukkale Univ, Denizli, Turkey

[8] Duzce Univ, Med Sch Infect Dis & Clin Microbiol, Duzce, Turkey

[9] Erciyes Univ, Fac Med, Kayseri, Turkey

[10] German Hosp, Istanbul, Turkey

[11] Ege Univ, Fac Med, Izmir, Turkey

[12] Harran Univ, Fac Med, Sanliurfa, Turkey

来源：

AMERICAN JOURNAL OF INFECTION CONTROL | 2013年 / 41卷 / 10期

关键词：

Hospital infection; Nosocomial infection; Health care-acquired infection; Device-associated infection; Catheter-related urinary tract infections; Urinary catheter; Developing countries; Limited resources countries; Low-income countries; Emerging countries; Surveillance; Critical care; Incidence density; Bundle; Hand hygiene; Handwashing; DEVICE-ASSOCIATED INFECTIONS; SOCIOECONOMIC IMPACT; COUNTRIES; SURVEILLANCE; EDUCATION;

D O I：

10.1016/j.ajic.2013.01.028

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

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.

引用

页码：885 / 891

页数：7

共 27 条

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