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Hospital-acquired infections and mortality worldwide

Reviewed by Zachary Willis, MD MPH; UNC School of Medicine, Chapel Hill, NC

Hospital-acquired infections (HAIs) are well known to be associated with increased healthcare costs, increased length of stay, and greater risk of mortality. Investigators representing the long-running International Nosocomial Infection Control Consortium (INICC) report a prospective cohort study of the impact of HAIs on in-hospital all-cause mortality conducted over a 24-year span in a total of 287 hospitals in 37 countries, spanning from lower-middle income to high income countries. They used rigorous surveillance methodology, with an infection prevention practitioner (IPP) visiting the bedside of each patient admitted to a participating ICU daily (duration of ICU participation was variable). When a potential infection was identified, the IPP applied CDC NHSN surveillance criteria to identify HAIs. They reported similar device utilization as reported by CDC NHSN in American ICUs, but rates of HAIs were significantly higher, which may be attributed to the diversity of IP resources in the settings included. Multivariable logistic regression was used to identify the following risk factors for in-hospital mortality: CLABSI (aOR 1.84), VAP (aOR 1.48), and CAUTI (aOR 1.18). This report highlights the critical worldwide need for HAI prevention.

Reference:
Rosenthal VD, Yin R, Lu Y, et al. The Impact of Healthcare-Associated Infections on Mortality in ICU: A Prospective Study in Asia, Eastern Europe, Latin America, and the Middle East. American Journal of Infection Control. 2022;0(0). doi:10.1016/j.ajic.2022.08.024

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