Background
Methods
Results
Conclusions
Key Words
- Rosenthal V.D.
- Maki D.G.
- Rodrigues C.
- Álvarez-Moreno C.
- Leblebicioglu H.
- Sobreyra-Oropeza M.
- International Nosocomial Infection Control Consortium Investigators
- et al.
Methods
Baseline assessment of hospitals
Formation of a panel of experts
Surveillance strategy and stepwise implementation of surveillance
Surveillance phases
Phase 1 surveillance (pilot)
Phase 2 surveillance
Phase 3 surveillance
Surveillance definitions
Electronic data entry and reporting
Laboratory procedures
Results of phase 2 surveillance
Infection rates
Hospital type | Bed size category | Total | ||
---|---|---|---|---|
51-200 | 201-500 | >500 | ||
Teaching hospitals | ||||
Pediatrics | 0 | 4 | 0 | 4 |
Obstetrics | 1 | 2 | 0 | 3 |
Surgical | 0 | 1 | 1 | 2 |
Medical | 0 | 1 | 1 | 2 |
General | 3 | 0 | 4 | 7 |
Others | 2 | 1 | 0 | 3 |
Public general hospitals | 3 | 3 | 0 | 6 |
Private | 0 | 1 | 0 | 1 |
Total | 9 | 13 | 6 | 28 |
Type of location | No. of ICUs | No. of HAIs reported | Patient days | Pooled mean incidence of HAI | Pneumonia | Bloodstream infections | Urinary tract infections | |||
---|---|---|---|---|---|---|---|---|---|---|
n | Pooled mean | n | Pooled mean | n | Pooled mean | |||||
Burn | 3 | 29 | 6,834 | 4.2 | 6 | 0.9 | 16 | 2.3 | 7 | 1.0 |
Medical cardiac | 10 | 71 | 43,063 | 1.6 | 32 | 0.7 | 11 | 0.3 | 28 | 0.7 |
Medical critical care | 10 | 275 | 62,065 | 4.4 | 108 | 1.7 | 102 | 1.6 | 65 | 1.0 |
Medical-surgical | 13 | 279 | 69,900 | 4.0 | 116 | 1.7 | 61 | 0.9 | 102 | 1.5 |
Neurologic | 2 | 46 | 6,654 | 6.9 | 20 | 3.0 | 8 | 1.2 | 18 | 2.7 |
Neurosurgical | 8 | 229 | 29,382 | 7.8 | 109 | 3.7 | 45 | 1.5 | 75 | 2.6 |
NICU | 11 | 468 | 135,193 | 3.5 | 118 | 0.9 | 350 | 2.6 | NA | NA |
Pediatric cardiothoracic | 1 | 32 | 7,231 | 4.4 | 29 | 4.0 | 0 | 0.0 | 3 | 0.4 |
Pediatric medical | 9 | 70 | 32,738 | 2.1 | 28 | 0.9 | 38 | 1.2 | 4 | 0.1 |
Pediatric surgical | 3 | 13 | 5,220 | 2.5 | 0 | 0.0 | 10 | 1.9 | 3 | 0.6 |
Prenatal-surgical | 2 | 46 | 7,955 | 5.8 | 1 | 0.1 | 41 | 5.2 | 4 | 0.5 |
Respiratory | 4 | 65 | 16,097 | 4.0 | 20 | 1.2 | 21 | 1.3 | 24 | 1.5 |
Surgical cardiothoracic | 5 | 17 | 13,827 | 1.2 | 7 | 0.5 | 7 | 0.5 | 3 | 0.2 |
Surgical critical care | 7 | 209 | 35,190 | 5.9 | 74 | 2.1 | 81 | 2.3 | 54 | 1.5 |
Trauma | 3 | 49 | 3,195 | 15.3 | 18 | 5.6 | 21 | 6.6 | 10 | 3.1 |
Total | 91 | 1,904 | 474,544 | 4.0 | 686 | 1.4 | 812 | 1.7 | 400 | 0.9 |
ICU type | No. of ICUs | Patient days | VAP | CLABSI | CAUTI | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | MV days | Rate | DUR | n | CL days | Rate | DUR | n | UC days | Rate | DUR | |||
Burn | 3 | 6,834 | 3 | 741 | 4.0 | 0.1 | 13 | 5,008 | 2.6 | 0.7 | 7 | 5,531 | 1.3 | 0.8 |
Medical cardiac | 10 | 43,063 | 22 | 2,021 | 10.9 | 0.0 | 4 | 6,052 | 0.7 | 0.1 | 27 | 10,602 | 2.5 | 0.2 |
Medical critical care | 10 | 62,065 | 64 | 17,019 | 3.8 | 0.3 | 76 | 34,403 | 2.2 | 0.6 | 63 | 41,130 | 1.5 | 0.7 |
Medical-surgical | 13 | 69,900 | 104 | 29,330 | 3.5 | 0.4 | 58 | 44,888 | 1.3 | 0.6 | 102 | 56,371 | 1.8 | 0.8 |
Neurologic | 2 | 6,654 | 0 | 230 | 0.0 | 0.0 | 5 | 1,954 | 2.6 | 0.3 | 17 | 4,980 | 3.4 | 0.7 |
Neurosurgical | 8 | 29,382 | 76 | 12,328 | 6.2 | 0.4 | 33 | 19,576 | 1.7 | 0.7 | 75 | 27,573 | 2.7 | 0.9 |
Neonatal intensive care | 11 | 135,193 | 115 | 25,029 | 4.6 | 0.2 | 198 | 26,958 | 7.3 | 0.2 | NA | NA | NA | NA |
Pediatric cardiothoracic | 1 | 7,231 | 15 | 2,445 | 6.1 | 0.3 | 0 | 5,759 | 0.0 | 0.8 | 3 | 1,892 | 1.6 | 0.3 |
Pediatric medical | 9 | 32,738 | 25 | 11,533 | 2.2 | 0.4 | 19 | 12,111 | 1.6 | 0.4 | 4 | 9,866 | 0.4 | 0.3 |
Pediatric surgical | 3 | 5,220 | 0 | 1,032 | 0.0 | 0.2 | 7 | 1,513 | 4.6 | 0.3 | 3 | 904 | 3.3 | 0.2 |
Prenatal-surgical | 2 | 7,955 | 1 | 793 | 1.3 | 0.1 | 25 | 2,800 | 8.9 | 0.4 | 4 | 6,706 | 0.6 | 0.8 |
Respiratory | 4 | 16,097 | 16 | 6,145 | 2.6 | 0.4 | 13 | 6,747 | 1.9 | 0.4 | 23 | 10,508 | 2.2 | 0.7 |
Surgical cardiothoracic | 5 | 13,827 | 6 | 2,078 | 2.9 | 0.2 | 5 | 9,023 | 0.6 | 0.7 | 3 | 6,495 | 0.5 | 0.5 |
Surgical critical care | 7 | 35,190 | 61 | 10,851 | 5.6 | 0.3 | 39 | 19,888 | 2.0 | 0.6 | 52 | 26,663 | 2.0 | 0.8 |
Trauma | 3 | 3,195 | 15 | 1,194 | 12.6 | 0.4 | 20 | 2,185 | 9.2 | 0.7 | 10 | 3,025 | 3.3 | 0.9 |
Total | 91 | 474,544 | 523 | 122,769 | 4.3 | 0.3 | 515 | 198,865 | 2.6 | 0.4 | 399 | 213,901 | 1.9 | 0.5 |
Organisms causing HAIs
Pathogen type and pattern of resistance | n | Resistance, n (%) |
---|---|---|
Klebsiella spp | 355 | |
ESBL production | 151 (42.5) | |
Carbapenem resistance | 171 (48.1) | |
Acinetobacter spp | 169 | |
Multidrug resistance | 157 (92.8) | |
Pseudomonas spp | 117 | |
Multidrug resistance | 70 (59.8) | |
Escherichia coli | 87 | |
ESBL production | 47 (54.0) | |
Carbapenem resistance | 12 (13.8) | |
Staphylococcus aureus | 71 | |
MRSA | 56 (78.9) | |
Enterococcus spp | 20 | |
VRE | 7 (35.0) | |
Coagulase-negative staphylococci | 91 | |
Candida albicans | 116 | |
Proteus spp | 45 | |
Others | 164 | |
Total | 1,235 |
Discussion
- Sievert D.M.
- Ricks P.
- Edwards J.R.
- Schneider A.
- Patel J.
- Srinivasan A.
- et al.
- Sievert D.M.
- Ricks P.
- Edwards J.R.
- Schneider A.
- Patel J.
- Srinivasan A.
- et al.
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Article info
Publication history
Footnotes
Funding/Support: Supported by the U.S. Agency for International Development (USAID-Egypt), Work Unit 263-T-14-0001.
Conflicts of Interest: None to report.
Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, U.S. Government, the Centers for Disease Control and Prevention, or the Egyptian Ministry of Health and Population.
Additional Information: This protocol was approved by the Institutional Review Board at the U.S. Naval Medical Research Unit No. 3, Cairo, as a nonhuman research activity protocol no. 1114. M.T., M.E.-S., and S.K. are contractors of the U.S. Government. This work was prepared as part of their official duties.
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