Device-associated infection rates, bacterial resistance, length of stay, and mortality in Kuwait: International Nosocomial Infection Consortium findings

Am J Infect Control. 2016 Apr 1;44(4):444-9. doi: 10.1016/j.ajic.2015.10.031. Epub 2016 Jan 5.

Abstract

Background: To report the results of the International Infection Control Consortium (INICC) study conducted in Kuwait from November 2013-March 2015.

Methods: A device-associated health care-acquired infection (DA-HAI) prospective surveillance study in 7 adult, pediatric, and neonatal intensive care units (ICUs) using the U.S. Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) definitions and INICC methods.

Results: We followed 3,732 adult and pediatric patients for 21,611 bed days and 671 neonatal patients for 4,515 bed days. In the medical-surgical ICUs, the central line-associated bloodstream infection (CLABSI) rate was 3.5 per 1,000 central line days, the ventilator-associated pneumonia (VAP) rate was 4.0 per 1,000 mechanical ventilator days, and the catheter-associated urinary tract infection (CAUTI) rate was 3.3 per 1,000 urinary catheter days; all of them were lower than INICC rates (CLABSI: 4.9; VAP: 16.5; and CAUTI: 5.3) and higher than NHSN rates (CLABSI: 0.9; VAP: 1.1; and CAUTI: 1.2). Resistance of Staphylococcus aureus to oxacillin was 100%, resistance of Acinetobacter baumannii to imipenem and meropenem was 77.6%, and resistance of Klebsiella pneumoniae to imipenem and meropenem was 29.4%. Extra length of stay was 27.1 days for CLABSI, 22.2 days for VAP, and 19.2 days for CAUTI in adult and pediatric ICUs. Extra crude mortality was 19.9% for CLABSI, 30.9% for VAP, and 11.1% for CAUTI in adult and pediatric ICUs.

Conclusions: DA-HAI rates in our ICUs are higher than the CDC-NSHN rates and lower than the INICC international rates.

Keywords: Hospital infection; antibiotic resistance; bloodstream infection; catheter-associated urinary tract infection; central line–associated bloodstream infections; health care–associated infection; network; nosocomial infection; urinary tract infection; ventilator-associated pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Bacteria / drug effects*
  • Bacteria / isolation & purification
  • Bacterial Infections / epidemiology
  • Bacterial Infections / mortality
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / mortality*
  • Child
  • Child, Preschool
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Kuwait / epidemiology
  • Length of Stay
  • Male
  • Middle Aged
  • Pneumonia, Ventilator-Associated / epidemiology*
  • Pneumonia, Ventilator-Associated / mortality*
  • Prevalence
  • Prospective Studies
  • Survival Analysis