K-3428. Mortality, Length of Stay, and Bacterial Resistance of Device-Associated Infections in 107 Intensive Care Units of 19 Developing Countries: Findings of INICC
Session: Poster Session: Device Related Infections
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: To determine bacterial resistance, extra mortality (EM) and length of stay (LOS) of device-associated infections (DAI) in INICC ICUs. Methods: Prospective cohort, active DAI surveillance was conducted on 107 adult, pediatric and neonatal ICUs of 47 cities in Argentina, Brazil, Chile, China, Colombia, Costa Rica, Cuba, India, Kosovo, Lebanon, Macedonia, Mexico, Morocco, Nigeria, Peru, Philippines, El Salvador, Turkey and Uruguay. CDC-NNIS definitions were applied. Protocol and forms were developed by INICC. Data were collected in the ICUs, and uploaded and analyzed at INICC offices.
Results: From 01/02 to 03/08, 45736 patients were enrolled.
AgentOverall DAI PercentageResistance
Pseudomonas sp19%37% to Imipenem
Acinetobacter sp15%81% to piperaciline-tazobactam
S aureus15%81% to methicilin
Klebsiella sp11%69% to ceftazidime
E. Coli9%56% to ceftazidime
Coagulase-negative-staphylococci6%78% to methicilin
Enterobacter sp5%61% to ceftazidime; 7% to Imipenem
Enterococcus sp3%7% to vancomycin

Without DAI, 14.5% of patients died; with CLABSI 31%, (EM 16.5% (RR, 2.13.; 95% CI, 1.92 - 2.36; P, < 0.001)); with VAP 41.4%, (EM 26.9% (RR, 2.85; 95% CI, 2.62 - 3.09; P, < 0.001)); with CAUTI 36.2% (EM 21.7% (RR, 2.48; 95% CI, 2.19 - 2.82; P, < 0.001)). Without DAI, LOS was 4.9 days; with CLABSI, 16.4 days (RR, 3.35) (11.5 extra days); with VAP, 15.2 days (RR, 3.10) (10.3 extra days); and with CAUTI, 13.9 days (RR, 2.83) (9 extra days). Conclusions: This study found high bacterial resistance, and that DAI increased significantly LOS, and mortality.
INICC Group, D Arman, Prof, MD, Gazi Univ Med School, F Udwadia, MD, Breach Candy Hosp. Trust, H Guanche Garcell, MD, ¨Joaquín Albarrán Domínguez¨ Univ Hosp., J AiQin, MD, The First Affiliated Hosp. of Guangxi Med Univ, S Abubakar, RN, Aminu Kano Teaching Hosp., S Kanj-Sharara, MD, American Univ of Beirut Med Center, V Rosenthal, MD, CIC, MSc,, International Nosocomial Infection Control Consortium, Buenos Aires, Argentina, Y Hussain, MD, Shaukat Khanum Cancer Hosp. & Research Centre and  V. D. Rosenthal, None.

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