{"id":927,"date":"2023-04-15T12:51:32","date_gmt":"2023-04-15T15:51:32","guid":{"rendered":"https:\/\/www.inicc.org\/site\/?p=927"},"modified":"2023-04-15T12:53:47","modified_gmt":"2023-04-15T15:53:47","slug":"risk-factors-central-line-associated-bloodstream-infections-low-income-countries","status":"publish","type":"post","link":"https:\/\/www.inicc.org\/site\/2023\/04\/15\/risk-factors-central-line-associated-bloodstream-infections-low-income-countries\/","title":{"rendered":"Risk Factors for Central Line Associated Bloodstream Infections in 41 Countries"},"content":{"rendered":"<h4 style=\"font-weight: 400;\"><strong>Multinational prospective study of incidence and risk factors for central line-associated bloodstream infections in 728 ICUs of 41 Asian, African, Eastern European, Latin American and Middle Eastern countries over 24 years<\/strong><\/h4>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\"><strong>Objective:\u00a0<\/strong>Identify central line (CL)-associated bloodstream infections (CLABSI) incidence and risk factors (RF) in low and middle-income countries (LMIC).<\/p>\n<p style=\"font-weight: 400;\"><strong>Design:\u00a0<\/strong>From 07\/01\/1998 to 02\/12\/2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms.<\/p>\n<p style=\"font-weight: 400;\"><strong>Setting:\u00a0<\/strong>728 ICUs of 286 hospitals in 147 cities in\u00a041 African,\u00a0Asian, Eastern-European, Latin-American, and Middle-Eastern\u00a0countries.<\/p>\n<p style=\"font-weight: 400;\"><strong>Patients:\u00a0<\/strong>278,241 patients, followed during 1,815,043\u00a0patient-days, acquired 3,537 CLABSIs.<\/p>\n<p style=\"font-weight: 400;\"><strong>Methods:\u00a0<\/strong>The CLABSI rate had CL-days as denominators and the number of CLABSIs as numerators.\u00a0Using multiple logistic regression outcomes are shown as adjusted odds ratios (aOR).<\/p>\n<p style=\"font-weight: 400;\"><strong>Results:\u00a0<\/strong>Pooled CLABSI rates is 4.82 CLABSI per 1,000 CL-days, significantly higher than the CDC NHSN.\u00a0We analyzed 11 variables, and following variables were independently significantly associated with CLABSI:\u00a0Length of stay (LOS), rising risk 3% daily (aOR=1.03;95%CI=1.03-1.04;p&lt;0.0001), number of CL-days, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.04;p&lt;0.0001), surgical hospitalization (aOR=1.12;95%CI=1.03-1.21;p&lt;0.0001), tracheostomy use (aOR=1.52;95%CI=1.23-1.88;p&lt;0.0001), hospitalized at a publicly-owned facility (aOR=3.04;95%CI=2.31-4.01;p&lt;0.0001) or at a teaching-hospital (aOR=2.91;95%CI=2.22-3.83;p&lt;0.0001), located at a middle-income country (aOR=2.41;95%CI=2.09-2.77;p&lt;0.0001). ICU with highest risk was adult-oncology (aOR=4.35;95%CI=3.11-6.09;p&lt;0.0001), followed by pediatric-oncology (aOR=2.51;95%CI=1.57-3.99;p&lt;0.0001), and pediatric (aOR=2.34;95%CI=1.81-3.01;p&lt;0.0001) ICU. CL with the highest risk was internal-jugular (aOR=3.01;95%CI=2.71-3.33;p&lt;0.0001), followed by femoral (aOR=2.29;95%CI=1.96-2.68;p&lt;0.0001). PICC (aOR=1.48;95%CI=1.02-2.18;p=0.04) was the CL with the lowest CLABSI risk.<\/p>\n<p style=\"font-weight: 400;\"><strong>Conclusions:\u00a0<\/strong>The following CLABSI\u00a0RFs are unlikely to change: country income level, facility ownership, hospitalization type, and ICU type. Based on these findings it is suggested to focus on reducing LOS, CL-days, and tracheostomy; using PICC instead of internal-jugular or femoral; and implementing evidence-based CLABSI prevention recommendations.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Title:\u00a0<\/strong><span lang=\"EN-US\">Rosenthal VD,\u00a0<\/span><span lang=\"EN-US\">Ruijie Yin<b>,\u00a0<\/b><\/span>Sheila Nainan Myatra, Ziad A. Memish, Camilla Rodrigues, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Majeda Afeef Al-Ruzzieh, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan,<sup>\u00a0 <\/sup>Luisa Fernanda Jim\u00e9nez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Yin Hoong Lai, Katherine Gomez, Daisy Aguilar De Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jaros\u0142aw Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George\u00a0 Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya,\u00a0 Reshma Dongol, Vesna Mioljevi\u0107,\u00a0 Lul Raka.\u00a0 Lourdes Due\u00f1as,\u00a0 Nilton Yhuri Carreazo, <sup>\u00a0<\/sup>Tarek Dendane,\u00a0 Aamer Ikram,\u00a0 Tala Kardas, Michael M. Petrov,\u00a0 Asma Bouziri,\u00a0 Nguyen Viet Hung,\u00a0 Vladislav Belskiy, Naheed Elahi,\u00a0 Estuardo Salgado. <em><strong>Multinational prospective study of incidence and risk factors for central line-associated bloodstream infections in 728 ICUs of 41 Asian, African, Eastern European, Latin American and Middle Eastern countries over 24 years<\/strong><\/em>.\u00a0<span lang=\"EN-US\">Infection Control And Hospital Epidemiology<\/span><i><\/i><b style=\"font-style: inherit;\"><i><span lang=\"EN-US\">.\u00a0<\/span><\/i><\/b>Accepted for publication and in Press. 2023.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Multinational prospective study of incidence and risk factors for central line-associated bloodstream infections in 728 ICUs of 41 Asian, African, Eastern European, Latin American and Middle Eastern countries over 24 years &nbsp; Objective:\u00a0Identify central line (CL)-associated bloodstream infections (CLABSI) incidence and risk factors (RF) in low and middle-income countries (LMIC). Design:\u00a0From 07\/01\/1998 to 02\/12\/2022, we [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[4],"tags":[],"class_list":["post-927","post","type-post","status-publish","format-standard","hentry","category-hai-rates"],"_links":{"self":[{"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/posts\/927","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/comments?post=927"}],"version-history":[{"count":3,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/posts\/927\/revisions"}],"predecessor-version":[{"id":929,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/posts\/927\/revisions\/929"}],"wp:attachment":[{"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/media?parent=927"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/categories?post=927"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.inicc.org\/site\/wp-json\/wp\/v2\/tags?post=927"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}