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566 Device-associated Infection (DAI) Rates in a High Risk Nursery Unit (HRN-U), in a Brazilian Tertiary Teaching General Hospital- a One-Decade Comparative Study

Sunday, April 3, 2011
Trinity Ballroom (Hilton Anatole)
R. M. C. R. Regina Mara Custódio Rangel, NURSE , Fundação Faculdade Regional de Medicina de Rio Preto, São José do Rio Preto, Brazil
Fernando G. Rubio, MD , Fundação Faculdade Regional de Medicina de Rio Preto, São José do Rio Preto, Brazil
Marcia W. Catelan, MD , Hospital de Base de São José do Rio Preto, São José do Rio Preto, Brazil
Background:

The rates of health care-associated infections in developing countries are three to five times higher than international standards.

Objective:

To measure the incidence of DAI in a HRN-U and compare with US-CDC and INICC NNIS data.

Methods: Our institution is an 700 bed tertiary teaching general hospital. Of three pediatric units, one HRN-U with a total of 11 beds was evaluated. We used one decade of prospective pooled means using CDC/NNIS surveillance definitions. It was stratified by weight (Kg) <1.000, 1.001-1.500, 1.501-2.500, >2.500, and denominator data all collected per 1000 devices/days for central line (CL) - associated bloodstream infection  (ABSI) laboratory confirmed and ventilator - associated pneumonia (VAP).

Results: During January/99 to December/2008, for an aggregate 32531 patients days, 264 DAI were acquired, at an overall rate of 8.11 DAI per 1000 ICU days. We compared with the following CDC/INNIC data, according to the weight, respectively: for CLABSI 9.1/11.41, 5.4/15.9, 4.1/13.8, 3.5/11.7, and for VAP 3.5/7.42, 2.4/8.19, 1.9/9.64, 1.4/11.82. We found for CLABSI/VAP, respectively: 4.69/8.41, 5.57/8.97, 6.67/8.84, 5.32/3.14. Our results indicate better control in very low weight population for CLABSI similar to CDC and superior to INNIC. Nevertheless, VAP was similar to INNIC, but almost two to five times more than CDC data.

Conclusions: Our infection control program must be aimed at improving the prevention of CLABSI in the high weight category and VAP in all populations.