Journal of Infection and Public Health (Sep 2018)

Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

  • Hail M. Al-Abdely,
  • Yassir Khidir Mohammed,
  • Victor D. Rosenthal,
  • Pablo W. Orellano,
  • Mohamed ALazhary,
  • Eman Kaid,
  • Anan Al-Attas,
  • Ghadeer Hawsawi,
  • Ashraf Kelany,
  • Bedoor Hussein,
  • Bayan Esam,
  • Rami Altowerqi,
  • Modhi A. Alkamaly,
  • Nader A. Tawfic,
  • Elinita Cruzpero,
  • Raya M. Al Rashidi,
  • Reny Thomas,
  • Apsia M. Molano,
  • Hessa A. Al Enazy,
  • Fatima M. Al Adwani,
  • Arlu M. Casuyon Pahilanga,
  • Sharifa Alatawi,
  • Raslan Nakhla,
  • Fatma M. Al Adwani,
  • Rosita Gasmin Aromin,
  • Evangelina Balon Ubalde,
  • Hanan Hanafy Diab,
  • Nahla A. Kader,
  • Ibtesam Y. Hassan Assiry,
  • Fahad A. Sawan,
  • Hassan E. Ammari,
  • Alhasan M. Mashiakhy,
  • Elaine B. Santiago,
  • Christian M.S. Chua,
  • Imee M. Dalis,
  • Haider M. Arishi,
  • Ruthelma Lozada,
  • Ibrahim A.M. Al-Zaydani Asiri,
  • Hala Ahmed,
  • Al Jarie,
  • Ali S.M. Al-Qathani,
  • Halima Y. Al-Alkami,
  • Mervat AlDalaton,
  • Siti J.B. Alih,
  • Mohammed J. Alaliany,
  • Najla J. Helali,
  • Grace Sindayen,
  • Annalyn A. Malificio,
  • Haya B. Al Dossari,
  • Abdulmajid G. Algethami,
  • Dia Mohamed,
  • Leigh Yanne,
  • Avigail Tan,
  • Sheema Babu,
  • Shatha M. Abduljabbar,
  • Hala Rushdi,
  • Janice Fernandez,
  • Waleed M. Hussain,
  • Renuga D. Rajavel,
  • Syed Z. Bukhari,
  • Abdullah A. Turkistani,
  • Jeyashri J. Mushtaq,
  • Eida Albeladi,
  • Sally Aboushoushah,
  • Nahed Qushmaq,
  • Leide Shyrine,
  • Jomol Philipose,
  • Mohamed Raees,
  • Nawal S. AbdulKhalik,
  • Marjory Madco,
  • Mohd Abdulghany,
  • Athena Manao,
  • Catherine Acostan,
  • Rania Safwat,
  • Muhammad Halwani,
  • Nahla A.H. Abdul Aal,
  • Anumol Thomas,
  • Shaymaa M. Abdulatif,
  • Nelia C. Ariola,
  • Aisha H. Mutwalli,
  • Nelia Ariola,
  • Eatedal Bohlega,
  • Saly Simon,
  • Estelita Damlig,
  • Sherin G. Elsherbini,
  • Ilama T. Krishne,
  • Sheela Abraham,
  • Mohammed A. Ali Karrar,
  • Nisreen A. Gosn,
  • Abdulaziz A. Al Hindi,
  • Rasha N. Jaha,
  • Saeda M. AlQahtani,
  • Ali O. Abdul Aziz,
  • Nadia L. Demaisip,
  • Elizabeth Laungayan Cortez,
  • Analen F. Cabato,
  • Jerlie M. Gonzales Celiz,
  • Mohammed A. Al Raey,
  • Saeed A. Al Darani,
  • Misbah R. Aziz,
  • Batool A. Manea,
  • Eslam Samy,
  • Solita Briones,
  • Radhika Krishnan,
  • Saman S.M. Raees,
  • Kehkashan Tabassum,
  • Khalid M. Ghalilah,
  • Mohamed Alradady,
  • Abdulrahim Al Qatri,
  • Mafaten Chaouali,
  • Magdy Elsisi,
  • Hajer A. Aldossary,
  • Shehab Al-Suliman,
  • Amina A. Al Talib,
  • Nadira Albaghly,
  • Mohammad E. Haqlre Mia,
  • Manal M. Al-Gethamy,
  • Dhafer M. Alamri,
  • Adnan S. Al-Saadi,
  • Evelyn P. Ayugat,
  • Nawaf A. Al Hazazi,
  • Modi I. Al Hussain,
  • Yvonne Caminade,
  • Ann J. Santos,
  • Mohamed H. Abdulwahab,
  • Bushra T.A. Al-Garni

Journal volume & issue
Vol. 11, no. 5
pp. 677 – 684

Abstract

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Background: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. Methods: A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. Results: The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Conclusions: Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia. Keywords: Hospital infection, Healthcare-acquired infection, Hospital-acquired pneumonia, Nosocomial pneumonia, Limited-resource countries, Surveillance