International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module.
Victor D Rosenthal, Ruijie Yin, Patricio Nercelles, Sara E Rivera-Molina, Somani Jyoti, Reshma Dongol, Daisy Aguilar-De-Moros, Nellie Tumu, Johana Alarcon-Rua, Juan P Stagnaro, Safaa Alkhawaja, Luisa F Jimenez-Alvarez, Yuliana A Cano-Medina, Sandra L Valderrama-Beltran, Claudia M Henao-Rodas, Maria A Zuniga-Chavarria, Amani El-Kholy, Hala Mounir Agha, Suneeta Sahu, Siksha O Anusandhan, Mahuya Bhattacharyya, Mohit Kharbanda, Aruna Poojary, Pravin K Nair, Sheila N Myatra, Rajesh Chawla, Kavita Sandhu, Yatin Mehta, Prasad Rajhans, Farid Zand, Mohammad Abdellatif-Daboor, Chian-Wern Tai, Chin S Gan, Mohd-Basri Mat Nor, Guadalupe Aguirre-Avalos, Blanca E Hernandez-Chena, Alejandro Sassoe-Gonzalez, Isabel Villegas-Mota, Mary C Aleman-Bocanegra, Ider Bat-Erdene, Nilton Y Carreazo, Alex Castaneda-Sabogal, Jarosław Janc, Vladislav Belskiy, Sona Hlinkova, Dincer Yildizdas, Merve Havan, Alper Koker, Hulya Sungurtekin, Ener C Dinleyici, Ertugrul Guclu, Lili Tao, Ziad A Memish, Zhilin Jin
Author Information
Victor D Rosenthal: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA; Department of Infection Prevention, INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA. Electronic address: vdr21@miami.edu.
Ruijie Yin: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA.
Patricio Nercelles: Department of Infection Prevention, Clinica Los Carrera, Quilpue, Chile.
Sara E Rivera-Molina: Department of Infection Prevention, Hospital Maria Especialidades Pediátricas, Tegucigalpa, Honduras.
Somani Jyoti: Department of Infection Prevention, National University Hospital, Singapore, Singapore.
Reshma Dongol: Department of Infection Prevention, Grande International Hospital, Kathamandu, Nepal.
Daisy Aguilar-De-Moros: Department of Infection Prevention, Hospital Del Nino Dr Jose Renan Esquivel De Panama, Panama, Panama.
Nellie Tumu: Department of Infection Prevention, Port Moresby General Hospital, Port Moresby, Papua New Guinea.
Johana Alarcon-Rua: Department of Infection Prevention, Clinica Sebastian De Belalcazar, Cali, Colombia.
Juan P Stagnaro: Department of Infection Prevention, Instituto Central De Medicina, Provincia De Buenos Aires, La Plata, Argentina.
Safaa Alkhawaja: Department of Infection Prevention, Salmaniya Medical Complex, Manama, Bahrain.
Luisa F Jimenez-Alvarez: Department of Infection Prevention, Clinica Universitaria Colombia, Bogota, Colombia.
Yuliana A Cano-Medina: Department of Infection Prevention, Instituto Del Corazon De Bucaramanga, Bogota, Colombia.
Sandra L Valderrama-Beltran: Department of Infection Prevention, Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia.
Claudia M Henao-Rodas: Department of Infection Prevention, Department of Infection Prevention, Fundacion Hospital San Jose De Buga, Guadalajara De Buga, Colombia.
Maria A Zuniga-Chavarria: Department of Infection Prevention, Hospital Clinica Biblica, San Jose De Costa Rica, Costa Rica.
Amani El-Kholy: Department of Infection Prevention, Dar Alfouad Hospital 6th Of October City, 6th Of October City, Egypt.
Hala Mounir Agha: Department of Infection Prevention, Cairo University Specialized Pediatric Hospital Cardio Thoracic Icu, Cairo, Egypt.
Suneeta Sahu: Department of Infection Prevention, Apollo Hospital Bhubaneswar, Bhubaneswar, India.
Siksha O Anusandhan: Department of Infection Prevention, IMS And SUM Hospital, Bhubaneswar, India.
Mahuya Bhattacharyya: Department of Infection Prevention, Advanced Medicare Research Institute Dhakuria Unit, Kolkata, India.
Mohit Kharbanda: Department of Infection Prevention, Desun Hospital & Heart Institute Kolkata, Kolkata, India.
Aruna Poojary: Department of Microbiology, Breach Candy Hospital Trust, Mumbai, India.
Pravin K Nair: Department of Infection Prevention, Holy Spirit Hospital, Mumbai, India.
Sheila N Myatra: Department of Critical Care, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Rajesh Chawla: Department of Infection Prevention, Indraprastha Apollo Hospital Delhi, New Delhi, India.
Kavita Sandhu: Department of Infection Prevention, Max Super Speciality Hospital Saket Delhi, New Delhi, India.
Yatin Mehta: Department of Critical Care, Medanta The Medicity, New Delhi, India.
Prasad Rajhans: Department of Infection Prevention, Deenanath Mangeshkar Hospital And Research Center Erandwane Pune, Pune, India.
Farid Zand: Department of Infection Prevention, Nemazee Hospital Shiraz University Of Medical Sciences, Shiraz, Iran.
Mohammad Abdellatif-Daboor: Department of Infection Prevention, King Hussein Cancer Center, Amman, Jordan.
Chian-Wern Tai: Department of Infection Prevention, Universiti Kebangsaan Malaysia Specialist Children's Hospital, Kuala Lumpur, Malaysia.
Chin S Gan: Department of Infection Prevention, University Malaya Medical Centre Pediatric Intensive Care, Kuala Lumpur, Malaysia.
Mohd-Basri Mat Nor: Department of Infection Prevention, International Islamic University Malaysia Department Of Anesthesia And Critical Care, Kuantan, Malaysia.
Guadalupe Aguirre-Avalos: Department of Critical Care, Hospital Civil De Guadalajara Fray Antonio Alcalde Terapia Intensiva, Guadalajara, Mexico.
Blanca E Hernandez-Chena: Department of Infection Prevention, Hospital General Regional 6 De Ciudad Madero, Madero, Mexico.
Alejandro Sassoe-Gonzalez: Department of Infection Prevention, Hospital Regional De Alta Especialidad De Ixtapaluca, Ixtapaluca, Mexico.
Isabel Villegas-Mota: Department of Infection Prevention, Instituto Nacional De Perinatologia Unidad De Cuidados Intensivos Neonatales, Mexico City, Mexico.
Mary C Aleman-Bocanegra: Department of Infection Prevention, Hospital San José De Monterrey Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Ider Bat-Erdene: Department of Infection Prevention, Intermed Hospital, Ulaanbaatar, Mongolia.
Nilton Y Carreazo: Department of Infection Prevention, Hospital De Emergencias Pediatricas, Lima, Peru.
Alex Castaneda-Sabogal: Department of Infection Prevention, Hospital Victor Lazarte Echegaray, Trujillo, Peru.
Jarosław Janc: Department of Anesthesiology and Intensive Therapy, 4th Clinical Military Hospital with Polyclinic, Wroclaw, Poland.
Vladislav Belskiy: Department of Infection Prevention, Privolzhskiy District Medical Center, Nizhniy Novgorod, Russia.
Sona Hlinkova: Department of Infection Prevention, Catholic University In Ruzomberok Faculty Of Health Central Military Hospital Snp Ruzomberok, Ruzomberok, Slovakia.
Dincer Yildizdas: Department of Infection Prevention, Balcali Hospital Pediatric Intensive Care Unit, Adana, Turkey.
Merve Havan: Department of Infection Prevention, Ankara University Faculty Of Medicine, Ankara, Turkey.
Alper Koker: Department of Infection Prevention, Akdeniz University Medical School, Antalya, Turkey.
Hulya Sungurtekin: Department of Infection Prevention, Pamukkale University Hospital, Denizli, Turkey.
Ener C Dinleyici: Department of Infection Prevention, Eskisehir Osmangazi University, Eskisehir, Turkey.
Ertugrul Guclu: Department of Infection Prevention, Sakarya University Training And Research Hospital, Sakarya, Turkey.
Lili Tao: Department of Infection Prevention, Zhongshan Hospital, Fudan University, Shanghai, China.
Ziad A Memish: Department of Infection Prevention, King Saud Medical City, Ministry of Health, Riyadh, Arabia.
Zhilin Jin: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA.
BACKGROUND: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East. METHODS: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI). RESULTS: We gathered data from 204,770 patients, 1,480,620 patient days, 936,976 central line (CL)-days, 637,850 mechanical ventilators (MV)-days, and 1,005,589 urinary catheter (UC)-days. Our results showed 4,270 CL-associated bloodstream infections, 7,635 ventilator-associated pneumonia, and 3,005 UC-associated urinary tract infections. The combined rates of DA-HAIs were 7.28%, and 10.07 DA-HAIs per 1,000 patient days. CL-associated bloodstream infections occurred at 4.55 per 1,000 CL-days, ventilator-associated pneumonias at 11.96 per 1,000 MV-days, and UC-associated urinary tract infections at 2.91 per 1,000 UC days. In terms of resistance, Pseudomonas aeruginosa showed 50.73% resistance to imipenem, 44.99% to ceftazidime, 37.95% to ciprofloxacin, and 34.05% to amikacin. Meanwhile, Klebsiella spp had resistance rates of 48.29% to imipenem, 72.03% to ceftazidime, 61.78% to ciprofloxacin, and 40.32% to amikacin. Coagulase-negative Staphylococci and Staphylococcus aureus displayed oxacillin resistance in 81.33% and 53.83% of cases, respectively. CONCLUSIONS: The high rates of DA-HAI and bacterial resistance emphasize the ongoing need for continued efforts to control them.
