TY - JOUR
T1 - Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe
AU - Rosenthal, Victor Daniel
AU - Jin, Zhilin
AU - Yin, Ruijie
AU - Sahu, Suneeta
AU - Rajhans, Prasad
AU - Kharbanda, Mohit
AU - Nair, Pravin K.
AU - Mishra, Shakti Bedanta
AU - Chawla, Rajesh
AU - Arjun, Rajalakshmi
AU - Sandhu, Kavita
AU - Rodrigues, Camilla
AU - Dongol, Reshma
AU - Myatra, Sheila Nainan
AU - Mohd-Basri, Mat Nor
AU - Chian-Wern, Tai
AU - Bhakta, Arpita
AU - Bat-Erdene, Ider
AU - Acharya, Subhash P.
AU - Alvarez, Gustavo Andres
AU - Moreno, Lina Alejandra Aguilar
AU - Gomez, Katherine
AU - da Jimenez-Alvarez, Luisa Fernanda
AU - Henao-Rodas, Claudia Milena
AU - Valderrama-Beltran, Sandra Liliana
AU - Zuniga-Chavarria, Maria Adelia
AU - Aguirre-Avalos, Guadalupe
AU - Hernandez-Chena, Blanca Estela
AU - Sassoe-Gonzalez, Alejandro
AU - Aleman-Bocanegra, Mary Cruz
AU - Villegas-Mota, Maria Isabel
AU - De Moros, Daisy Aguilar
AU - Castaneda-Sabogal, Alex
AU - Carreazo, Nilton Yhuri
AU - Alkhawaja, Safaa
AU - Agha, Hala Mounir
AU - El-Kholy, Amani
AU - Abdellatif-Daboor, Mohammad
AU - Dursun, Oguz
AU - Okulu, Emel
AU - Havan, Merve
AU - Yildizdas, Dincer
AU - Deniz, Suna Secil Ozturk
AU - Guclu, Ertugrul
AU - Hlinkova, Sona
AU - Ikram, Aamer
AU - Tao, Lili
AU - Omar, Abeer Aly
AU - Elahi, Naheed
AU - Memish, Ziad A.
AU - Petrov, Michael M.
AU - Raka, Lul
AU - Janc, Jarosław
AU - Horhat-Florin, George
AU - Medeiros, Eduardo Alexandrino
AU - Salgado, Estuardo
AU - Dueñas, Lourdes
AU - Coloma, Monica
AU - Perez, Valentina
AU - Brown, Eric Christopher
N1 - Publisher Copyright:
© 2023
PY - 2024/4
Y1 - 2024/4
N2 - Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P < 0.001); 11.40 at the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P < 0.001), and to 9.68 at the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. Conclusions: This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.
AB - Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P < 0.001); 11.40 at the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P < 0.001), and to 9.68 at the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. Conclusions: This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.
KW - Developing countries
KW - Device-associated infection
KW - Healthcare-associated infection
KW - Hospital infection
KW - Limited resources countries
KW - Low-income countries
KW - Network
KW - Nosocomial infection
KW - Ventilator-associated pneumonia
UR - https://www.scopus.com/pages/publications/85180749651
U2 - 10.1016/j.jcrc.2023.154500
DO - 10.1016/j.jcrc.2023.154500
M3 - Artículo
C2 - 38128216
AN - SCOPUS:85180749651
SN - 0883-9441
VL - 80
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154500
ER -