Infection control bundles in intensive care: an international cross-sectional survey in low- and middle-income countries. Issue 3 (March 2019)

• Record Type: Journal Article
• Authors: Akhvlediani, T.; Akkoyunlu, Y.; Amela, D.L.; Aqel, A.; Bagırova, F.; Carevic, B.; Candevir-Ulu, A.; Cevahir, F.; Dijk, M.V.; Dobrevska, R.; Donlan, S.; Dragovac, G.; Dobrevska, R.; Fernandez, R.; Ikram, A.; Kamal, A.M.; Karagoz, E.; Kaynar, L.; Kulzhanova, S.; Kumar, A.; McLaws, M.L.; Mema, D.; Oztoprak, N.; Pepe, F.N.; Petri, O.; Popescu, C.; Presterl, E.; Raka, L.; Resat, M.; Senol, G.; Shresta, L.B.; Sonmezer, M.Ç.; Taqıyev, B.; Tekin, R.; Tiamiyu, B.; Ulu-Kilic, A.; Vandana, K.E.; Vecchio, R.F.D.; Wongsurakıat, P.; Alp, E.; Cookson, B.; Erdem, H.; Rello, J.;
• Is Part Of: Journal of hospital infection. Volume 101:Issue 3(2019)
• Page Start: 248
• Page End: 256
• Publication Date: 2019-03
• Subjects: Infection control -- Bundles -- Low and middle income -- Healthcare-associated infection -- Prevention -- Ventilator-associated pneumonia; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2018.07.022
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Background: In low- and middle-income countries (LMICs), the burden of healthcare-associated infections (HCAIs) is not known due to a lack of national surveillance systems, standardized infection definitions, and paucity of infection prevention and control (IPC) organizations and legal infrastructure. Aim: To determine the status of IPC bundle practice and the most frequent interventional variables in LMICs. Methods: A questionnaire was emailed to Infectious Diseases International Research Initiative (ID-IRI) Group Members and dedicated IPC doctors working in LMICs to examine self-reported practices/policies regarding IPC bundles. Responding country incomes were classified by World Bank definitions into low, middle, and high. Comparison of LMIC results was then made to a control group of high-income countries (HICs). Findings: This survey reports practices from one low-income country (LIC), 16 middle-income countries (MICs) (13 European), compared to eight high-income countries (HICs). Eighteen (95%) MICs had an IPC committee in their hospital, 12 (63.2%) had an annual agreed programme and produced an HCAI report. Annual agreed programmes (87.5% vs 63.2%, respectively) and an annual HCAI report (75.0% vs 63.2%, respectively) were more common in HICs than MICs. All HICs had at least one invasive device-related surveillance programme. Seven (37%) MICs had no invasive device-related surveillance programme, six (32%) had no ventilator-associated pneumonia prevention bundles, seven (37%) had no catheter-associated urinary tract infection prevention bundles, and five (27%) had no central line-associated bloodstream infection prevention bundles. Conclusion: LMICs need to develop their own bundles with low-cost and high-level-of-evidence variables adapted to the limited resources, with further validation in reducing infection rates.