Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East

Rosenthal VD 1 , Yin R 2 , Jin Z 2 , Perez V 3 , Kis MA 2 , Abdulaziz-Alkhawaja S 4 Show all authors , Valderrama-Beltran SL 5 , Gomez K 6 , Rodas CMH 7 , El-Sisi A 8 , Sahu S 9 , Kharbanda M 10 , Rodrigues C 11 , Myatra SN 12 , Chawla R 13 , Sandhu K 14 , Mehta Y 15 , Rajhans P 16 , Arjun R 17 , Tai CW 18 , Bhakta A 19 , Mat Nor MB 20 , Aguirre-Avalos G 21 , Sassoe-Gonzalez A 22 , Bat-Erdene I 23 , Acharya SP 24 , Aguilar-de-Moros D 25 , Carreazo NY 26 , Duszynska W 27 , Hlinkova S 28 , Yildizdas D 29 , Kılıc EK 30 , Dursun O 31 , Odek C 32 , Deniz SSO 33 , Guclu E 34 , Koksal I 35 , Medeiros EA 36 , Petrov MM 37 , Tao L 38 , Salgado E 39 , Dueñas L 40 , Daboor MA 41 , Raka L 42 , Omar AA 43 , Ikram A 44 , Horhat-Florin G 45 , Memish ZA 46 , Brown EC 2

Affiliations 

  • 1 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Infection Control, INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA. Electronic address: [email protected]
  • 2 Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, USA
  • 3 Department of Biological Sciences, Florida International University, Miami, USA
  • 4 Department of Infection Control, Salmaniya Medical Complex, Manama, Bahrain
  • 5 Department of Infection Control, Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia
  • 6 Department of Infection Control, Clinica Sebastian de Belalcazar, Cali, Colombia
  • 7 Department of Infection Control, Fundacion Hospital San Jose De Buga, Guadalajara de Buga, Colombia
  • 8 Department of Pediatric Cardiac ICU, Cairo University Specialized Pediatric Hospital, Cairo, Egypt
  • 9 Department of Critical Care, Apollo Hospital Bhubaneswar, Bhubaneswar, India
  • 10 Department of Critical Care, Desun Hospital, Kolkata, India
  • 11 Department of Infection Control, Pd Hinduja National Hospital And Medical Research Centre, Mumbai, India
  • 12 Department of Critical Care, Tata Memorial Hospital Homi Bhabha National Institute, Mumbai, India
  • 13 Department of Critical Care, Indraprastha Apollo Hospital Delhi, New Delhi, India
  • 14 Department of Critical Care, Max Super Speciality Hospital Saket Delhi, New Delhi, India
  • 15 Department of Critical Care, Medanta The Medicity, New Delhi, India
  • 16 Department of Critical Care, Deenanath Mangeshkar Hospital And Research Center Erandwane Pune, Pune, India
  • 17 Department of Critical Care, Kerala Institute Of Med Sciences Thiruvananthapuram, Thiruvananthapuram, India
  • 18 Department of Critical Care, Universiti Kebangsaan Malaysia Specialist Children's Hospital, Kuala Lumpur, Malaysia
  • 19 Department of Critical Care, University Malaya Medical Centre Pediatric Intensive Care, Kuala Lampur, Malaysia
  • 20 Department of Critical Care, International Islamic University Malaysia Department of Anesthesia and Critical Care, Kuantan, Malaysia
  • 21 Department of Critical Care, Hospital Civil De Guadalajara Fray Antonio Alcalde Terapia Intensiva, Guadalajara, Mexico
  • 22 Department of Infection Control, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico
  • 23 Department for Quality and Safety, Intermed Hospital, Ulaanbaatar, Mongolia
  • 24 Department of Infection Control, Grande International Hospital, Kathamandu, Nepal
  • 25 Department of Infection Control, Hospital del Nino Dr Jose Renan Esquivel de Panama, Panama, Panama
  • 26 Department of Infection Control, Universidad Peruana de Ciencias Aplicadas Hospital de Emergencias Pediatricas, Lima, Peru
  • 27 Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
  • 28 Department of Critical Care, Catholic University In Ruzomberok, Faculty of Health, Central Military Hospital SNP Ruzomberok, Ruzomberok, Slovakia
  • 29 Department of Pediatric Intensive Care, Balcali Hospital, Adana, Turkey
  • 30 Department of Critical Care, Ankara Training And Research Hospital, Ankara, Turkey
  • 31 Department of Critical Care, Akdeniz University Medical School, Antalya, Turkey
  • 32 Department of Critical Care, Uludag University Faculty of Medicine, Bursa, Turkey
  • 33 Department of Critical Care, Pamukkale University Hospital, Denizli, Turkey
  • 34 Department of Critical Care, Sakarya University Training And Research Hospital, Sakarya, Turkey
  • 35 Department of Critical Care, Karadeniz Technical University School of Medicine, Trabzon, Turkey
  • 36 Department of Infection Control, Hospital Sao Paulo, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • 37 Department of Microbiology, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
  • 38 Department of Pneumonology, Zhongshan Hospital, Fudan University, Shanghai, China
  • 39 Department of Infection Control, Hospital Marie Curie, Quito, Ecuador
  • 40 Department of Critical Care, Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
  • 41 Department of Infection Control, King Hussein Cancer Center, Amman, Jordan
  • 42 Department of Public Health, National Institute For Public Health, Prishtina, Kosovo
  • 43 Department of Infection Control, Infection Control Directorate. Ministry of Health, Kuwait City, Kuwait
  • 44 Department of Critical Care, Armed Forces Institute of Urology, Rawalpindi, Pakistan
  • 45 Department of Critical Care, University of Medicine and Pharmacy Victor Babes Timisoara Emergency Clinical County Hospital Romania,Timisoara, Romania
  • 46 Department of Infection Control, King Saud Medical City, Ministry of Health, Ryhad, Saudi Arabia
Am J Infect Control, 2024 Aug;52(8):906-914.
PMID: 38437883 DOI: 10.1016/j.ajic.2024.02.017

Abstract

BACKGROUND: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden.

METHODS: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries. The dependent variable was CAUTI per 1,000 UC days, assessed at baseline and throughout the intervention, in the second month, third month, 4 to 15 months, 16 to 27 months, and 28 to 39 months. Comparisons were made using a 2-sample t test, and the exposure-outcome relationship was explored using a generalized linear mixed model with a Poisson distribution.

RESULTS: Over the course of 978,364 patient days, 150,258 patients utilized 652,053 UC-days. The rates of CAUTI per 1,000 UC days were measured. The rates decreased from 14.89 during the baseline period to 5.51 in the second month (risk ratio [RR] = 0.37; 95% confidence interval [CI] = 0.34-0.39; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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