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An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)

Published online by Cambridge University Press:  14 January 2021

Victor Daniel Rosenthal Open the ORCID record for Victor Daniel Rosenthal [Opens in a new window] ,
Gustavo Jorge Chaparro ,
Eduardo Alexandrino Servolo-Medeiros ,
Dayana Souza-Fram ,
Daniela Vieira da Silva Escudero ,
Sandra Milena Gualtero-Trujillo ,
Rayo Morfin-Otero ,
Esteban Gonzalez-Diaz ,
Eduardo Rodriguez-Noriega  and
Miguel Angel Altuzar-Figueroa
...Show all authors
Victor Daniel Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium (INICC), City of Buenos Aires, Argentina
Gustavo Jorge Chaparro
Affiliation:
Adult Intensive Care Unit, Instituto Medico Platense SA, Province of Buenos Aires, La Plata, Argentina
Eduardo Alexandrino Servolo-Medeiros
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Dayana Souza-Fram
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Daniela Vieira da Silva Escudero
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Sandra Milena Gualtero-Trujillo
Affiliation:
Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia
Rayo Morfin-Otero
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Esteban Gonzalez-Diaz
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Eduardo Rodriguez-Noriega
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Miguel Angel Altuzar-Figueroa
Affiliation:
Hospital General De Zona UMAA No 1 Oaxaca, Demetrio Mayoral Pardo, Oaxaca de Juarez, Mexico
Guadalupe Aguirre-Avalos
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Julio César Mijangos-Méndez
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Federico Corona-Jiménez
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Blanca Estela Hernandez-Chena
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
Mohamed Rajab Abu-Jarad
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
Evelia Maria Diaz-Hernandez
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
María Guadalupe Miranda-Novales
Affiliation:
Hospital De Pediatria Centro Medico Nacional Siglo XXI IMSS, Mexico DF, Mexico
José Guillermo Vázquez-Rosales
Affiliation:
Hospital De Pediatria Centro Medico Nacional Siglo XXI IMSS, Mexico DF, Mexico
Daisy Aguilar-De-Morós
Affiliation:
Hospital del Niño Dr José Renán Esquivel, Panamá
Elizabeth Castaño-Guerra
Affiliation:
Hospital del Niño Dr José Renán Esquivel, Panamá
Gabriel Munoz-Gutierrez
Affiliation:
Hospital Clinica Biblica, San Jose de Costa Rica, Costa Rica
Nepomuceno Mejia
Affiliation:
Hospital General De La Plaza De La Salud, Santo Domingo, Dominican Republic
Jenia Johana Acebo-Arcentales
Affiliation:
Hospital Oncologico Solon Espinoza Ayala, Quito, Ecuador
Gabriela Di-Silvestre
Affiliation:
Hospital De Clinicas Caracas, Caracas, Venezuela
*
Author for correspondence: Victor Daniel Rosenthal, E-mail: victor_rosenthal@inicc.org
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Abstract

Background:

Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.

Methods:

International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.

Results:

In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).

The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.

Conclusions:

Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 9 , September 2021 , pp. 1098 - 1104
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Mermel, LA. Short-Term peripheral venous catheter-related bloodstream infections: a systematic review. Clin Infect Dis 2017;65:1757–1762.CrossRefGoogle ScholarPubMed
Zhang, L, Cao, S, Marsh, N, et al. Infection risks associated with peripheral vascular catheters. J Infect Prev 2016;17:207–213.CrossRefGoogle ScholarPubMed
Ruiz-Giardin, JM, Ochoa Chamorro, I, Velazquez Rios, L, et al. Bloodstream infections associated with central and peripheral venous catheters. BMC Infect Dis 2019;19:841.CrossRefGoogle ScholarPubMed
Maki, DG, Kluger, DM, Crnich, CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006;81:1159–1171.CrossRefGoogle ScholarPubMed
Soifer, NE, Borzak, S, Edlin, BR, Weinstein, RA. Prevention of peripheral venous catheter complications with an intravenous therapy team: a randomized controlled trial. Arch Intern Med 1998;158:473–477.CrossRefGoogle ScholarPubMed
Aygun, G, Yasar, H, Yilmaz, M, et al. The value of gram staining of catheter segments for rapid detection of peripheral venous catheter infections. Diagn Microbiol Infect Dis 2006;54:165–167.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Bat-Erdene, I, Gupta, D, et al. Six-Year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings. Infect Control Hosp Epidemiol 2020;41:553–563.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Belkebir, S, Zand, F, et al. Six-Year multicenter study on short-term peripheral venous catheter–related bloodstream infection rates in 246 intensive units of 83 hospitals in 52 cities of 14 countries of Middle East: Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates-International Nosocomial Infection Control Consortium (INICC) findings. J Infect Public Health 2020.CrossRefGoogle ScholarPubMed
Pujol, M, Hornero, A, Saballs, M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect 2007;67:22–29.CrossRefGoogle Scholar
Rosenthal, VD. International Nosocomial Infection Control Consortium (INICC) resources: INICC multidimensional approach and INICC surveillance online system. Am J Infect Control 2016;44:e81–e90.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Bat-Erdene, I, Gupta, D, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012–2017: device-associated module. Am J Infect Control 2020;48:423–432.CrossRefGoogle ScholarPubMed
CDC definition of bloodstream infection event (central-line–associated bloodstream infection and non–central-line–associated bloodstream infection). Centers for Disease Control and Prevention. https://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf. Published 2020. Accessed June 8, 2020.Google Scholar
Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute-care setting. Am J Infect Control 2008;36:309–332.CrossRefGoogle ScholarPubMed
Dalai, SK, Padhi, S, Padhi, A, Parida, B. Peripheral venous catheter–related bloodstream infection in the intensive care unit. Int J Ad Med 2018;5:668–673.CrossRefGoogle Scholar
Alexandrou, E, Ray-Barruel, G, Carr, PJ, et al. Use of short peripheral intravenous catheters: characteristics, management, and outcomes worldwide. J Hosp Med 2018;13(5). doi: 10.12788/jhm.3039.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Bat-Erdene, I, Gupta, D, et al. Six-Year study on peripheral venous catheter–associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings. J Vasc Access 2020. doi: 10.1177/1129729820917259.Google Scholar
Worth, LJ, Daley, AJ, Spelman, T, Bull, AL, Brett, JA, Richards, MJ. Central and peripheral line–associated bloodstream infections in Australian neonatal and paediatric intensive care units: findings from a comprehensive Victorian surveillance network, 2008–2016. J Hosp Infect 2018;99:55–61.CrossRefGoogle Scholar
Ray-Barruel, G, Xu, H, Marsh, N, Cooke, M, Rickard, CM. Effectiveness of insertion and maintenance bundles in preventing peripheral intravenous catheter–related complications and bloodstream infection in hospital patients: a systematic review. Infect Dis Health 2019;24:152–168.CrossRefGoogle ScholarPubMed
Rhodes, D, Cheng, AC, McLellan, S, et al. Reducing Staphylococcus aureus bloodstream infections associated with peripheral intravenous cannulae: successful implementation of a care bundle at a large Australian health service. J Hosp Infect 2016;94:86–91.CrossRefGoogle Scholar
Salm, F, Schwab, F, Geffers, C, Gastmeier, P, Piening, B. The implementation of an evidence-based bundle for bloodstream infections in neonatal intensive care units in Germany: a controlled intervention study to improve patient safety. Infect Control Hosp Epidemiol 2016;37:798–804.CrossRefGoogle ScholarPubMed
Saliba, P, Hornero, A, Cuervo, G, et al. Interventions to decrease short-term peripheral venous catheter-related bloodstream infections: impact on incidence and mortality. J Hosp Infect 2018;100(3):e178–e186.CrossRefGoogle ScholarPubMed
Freixas, N, Bella, F, LimÃ3n E, Pujol M, Almirante B, Gudiol F. Impact of a multimodal intervention to reduce bloodstream infections related to vascular catheters in non-ICU wards: a multicentre study. Clin Microbiol Infect 2013;19:838–844.CrossRefGoogle Scholar
DeVries, M, Valentine, M, Mancos, P. Protected clinical indication of peripheral intravenous lines: successful implementation. J Assoc Vasc Access 2016;21:89–92.CrossRefGoogle Scholar
Duncan, M, Warden, P, Bernatchez, SpF, Morse, D. A bundled approach to decrease the rate of primary bloodstream infections related to peripheral intravenous catheters. J Assoc Vasc Access 2018;23:15–22.CrossRefGoogle Scholar
Miliani, K, Taravella, R, Thillard, D, et al. Peripheral venous catheter–related adverse events: evaluation from a multicentre epidemiological study in France (the CATHEVAL Project). PLoS One 2017;12:e0168637.CrossRefGoogle Scholar
Sato, A, Nakamura, I, Fujita, H, et al. Peripheral venous catheter–related bloodstream infection is associated with severe complications and potential death: a retrospective observational study. BMC Infect Dis 2017;17:434.CrossRefGoogle ScholarPubMed
Ripa, M, Morata, L, Rodriguez-Nunez, O, et al. Short-Term peripheral venous catheter–related bloodstream infections: evidence for increasing prevalence of gram-negative microorganisms from a 25-year prospective observational study. Antimicrob Agents Chemother 2018;62(11).CrossRefGoogle ScholarPubMed
Bundle of the International Nosocomial Infection Control Consortium (INICC) to prevent central and peripheral line–related bloodstream infections. INICC website. http://www.inicc.org/static/docs/2016-11-10-INICC%20Recommendations%20to%20prevent%20BSI-%20English.pdf. Published 2017. Accessed June 19, 2020.Google Scholar
Rosenthal, VD, Maki, DG, Salomao, R, et al. Device-Associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 2006;145:582–591.CrossRefGoogle ScholarPubMed
Alkhawaja, S, Saeed, NK, Rosenthal, VD, et al. Impact of the International Nosocomial Infection Control Consortium’s multidimensional approach on central-line–associated bloodstream infection rates in Bahrain. J Vasc Access 2020;21:481–489.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Desse, J, Maurizi, DM, et al. Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of central-line–associated bloodstream infection in 14 intensive care units in 11 hospitals of 5 cities in Argentina. Infect Control Hosp Epidemiol 2018;39:445–451.CrossRefGoogle Scholar
Al-Abdely, HM, Alshehri, AD, Rosenthal, VD, et al. Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection. J Infect Prev 2017;18:25–34.CrossRefGoogle ScholarPubMed
Alvarez-Moreno, CA, Valderrama-Beltran, SL, Rosenthal, VD, et al. Multicenter study in Colombia: Impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central-line–associated bloodstream infection rates. Am J Infect Control 2016;44:e235–e241.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Duenas, L, Sobreyra-Oropeza, M, et al. Findings of the International Nosocomial Infection Control Consortium (INICC), part III: effectiveness of a multidimensional infection control approach to reduce central line-associated bloodstream infections in the neonatal intensive care units of 4 developing countries. Infect Control Hosp Epidemiol 2013;34:229–237.CrossRefGoogle ScholarPubMed
Leblebicioglu, H, Ozturk, R, Rosenthal, VD, et al. Impact of a multidimensional infection control approach on central-line–associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC). Ann Clin Microbiol Antimicrob 2013;12:10.CrossRefGoogle Scholar
Jaggi, N, Rodrigues, C, Rosenthal, VD, et al. Impact of an international nosocomial infection control consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India. Int J Infect Dis 2013;17:e1218–1224.CrossRefGoogle ScholarPubMed
Rosenthal, VD, Ramachandran, B, Villamil-Gomez, W, et al. Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection 2012;40:415–423.CrossRefGoogle Scholar
Rosenthal, VD, Maki, DG, Rodrigues, C, et al. Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central-line–associated bloodstream infection rates in the intensive care units of 15 developing countries. Infect Control Hosp Epidemiol 2010;31:1264–1272.CrossRefGoogle ScholarPubMed
Higuera, F, Rosenthal, VD, Duarte, P, Ruiz, J, Franco, G, Safdar, N. The effect of process control on the incidence of central venous catheter–associated bloodstream infections and mortality in intensive care units in Mexico. Crit Care Med 2005;33:2022–2027.CrossRefGoogle ScholarPubMed