Please use this identifier to cite or link to this item: http://cris.unibe.edu.do/handle/123456789/249
Title: Socioeconomic impact on device-associated infections in limited-resource neonatal intensive care units: findings of the INICC
Autores: Rosenthal, V. D.
Lynch, P.
Jarvis, W. R.
Khader, I. A.
Richtmann, R.
Jaballah, N. B.
Aygun, C.
Villamil-Gómez, W.
Dueñas, L.
Atencio-Espinoza, T.
Navoa-Ng, J. A.
Pawar, M.
Sobreyra-Oropeza, M.
Barkat, A.
Mejía, N.
Yuet-Meng, C.
Apisarnthanarak, A.
International Nosocomial Infection Control Consortium members
Researchers (UNIBE): Mejía, N. 
Research area: Ciencias de la Salud
Keywords: Central line associated blood stream infection; Ventilator associated pneumonia; Catheter associated urinary tract infection; Intensive care unit; Health care acquired infection; International nosocomial infection control consortium
Issue Date: 2011
Publisher: Springer-Verlag
Source: Infection, 39, 439-450
Journal: Infection 
metadata.dc.identifier.artno: 439
Volume: 39
Start page: 439
End page: 450
Abstract: 
Purpose: To evaluate the impact of country socioeconomic status and hospital type on device-associated healthcare-associated infections (DA-HAIs) in neonatal intensive care units (NICUs). Methods: Data were collected on DA-HAIs from September 2003 to February 2010 on 13,251 patients in 30 NICUs in 15 countries. DA-HAIs were defined using criteria formulated by the Centers for Disease Control and Prevention. Country socioeconomic status was defined using World Bank criteria. Results: Central-line-associated bloodstream infection (CLA-BSI) rates in NICU patients were significantly lower in private than academic hospitals (10.8 vs. 14.3 CLA-BSI per 1,000 catheter-days; p < 0.03), but not different in public and academic hospitals (14.6 vs. 14.3 CLA-BSI per 1,000 catheter-days; p = 0.86). NICU patient CLA-BSI rates were significantly higher in low-income countries than in lower-middle-income countries or upper-middle-income countries [37.0 vs. 11.9 (p < 0.02) vs. 17.6 (p < 0.05) CLA-BSIs per 1,000 catheter-days, respectively]. Ventilator-associated-pneumonia (VAP) rates in NICU patients were significantly higher in academic hospitals than in private or public hospitals [13.2 vs. 2.4 (p < 0.001) vs. 4.9 (p < 0.001) VAPs per 1,000 ventilator days, respectively]. Lower-middle-income countries had significantly higher VAP rates than low-income countries (11.8 vs. 3.8 per 1,000 ventilator-days; p < 0.001), but VAP rates were not different in low-income countries and upper-middle-income countries (3.8 vs. 6.7 per 1,000 ventilator-days; p = 0.57). When examined by hospital type, overall crude mortality for NICU patients without DA-HAIs was significantly higher in academic and public hospitals than in private hospitals (5.8 vs. 12.5%; p < 0.001). In contrast, NICU patient mortality among those with DA-HAIs was not different regardless of hospital type or country socioeconomic level. Conclusions: Hospital type and country socioeconomic level influence DA-HAI rates and overall mortality in developing countries.
URI: http://cris.unibe.edu.do/handle/123456789/249
DOI: 10.1007/s15010-011-0136-2
Appears in Collections:Publicaciones de la Facultad de Ciencias de la Salud

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