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. 2010 Mar;38(2):95-104.e2.
doi: 10.1016/j.ajic.2009.12.004.

International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009

Victor D Rosenthal  1 , Dennis G Maki, Silom Jamulitrat, Eduardo A Medeiros, Subhash Kumar Todi, David Yepes Gomez, Hakan Leblebicioglu, Ilham Abu Khader, María Guadalupe Miranda Novales, Regina Berba, Fernando Martín Ramírez Wong, Amina Barkat, Osiel Requejo Pino, Lourdes Dueñas, Zan Mitrev, Hu Bijie, Vaidotas Gurskis, S S Kanj, Trudell Mapp, Rosalía Fernández Hidalgo, Nejla Ben Jaballah, Lul Raka, Achilleas Gikas, Altaf Ahmed, Le Thi Anh Thu, María Eugenia Guzmán Siritt; INICC Members
Collaborators, Affiliations

International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009

Victor D Rosenthal et al. Am J Infect Control. 2010 Mar.

Abstract

We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).

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