Infection

, Volume 41, Issue 2, pp 447–456

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

  • H. Leblebicioglu
  • A. N. Yalcin
  • V. D. Rosenthal
  • I. Koksal
  • F. Sirmatel
  • S. Unal
  • H. Turgut
  • D. Ozdemir
  • G. Ersoz
  • C. Uzun
  • S. Ulusoy
  • S. Esen
  • F. Ulger
  • A. Dilek
  • H. Yilmaz
  • O. Turhan
  • N. Gunay
  • E. Gumus
  • O. Dursun
  • G. Yýlmaz
  • S. Kaya
  • H. Ulusoy
  • M. Cengiz
  • L. Yilmaz
  • G. Yildirim
  • A. Topeli
  • S. Sacar
  • H. Sungurtekin
  • D. Uğurcan
  • M. F. Geyik
  • A. Şahin
  • S. Erdogan
  • A. Kaya
  • N. Kuyucu
  • B. Arda
  • F. Bacakoglu
Clinical and Epidemiological Study

DOI: 10.1007/s15010-013-0407-1

Cite this article as:
Leblebicioglu, H., Yalcin, A.N., Rosenthal, V.D. et al. Infection (2013) 41: 447. doi:10.1007/s15010-013-0407-1

Abstract

Purpose

To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey.

Methods

A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach.

Results

In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42–0.7; P value, 0.0001.)

Conclusions

The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.

Keywords

International Nosocomial Infection Control ConsortiumHealth care acquired infectionVentilator associated pneumoniaDeveloping countriesAdult intensive care unitMultidimensional approach

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • H. Leblebicioglu
    • 1
  • A. N. Yalcin
    • 2
  • V. D. Rosenthal
    • 3
  • I. Koksal
    • 4
  • F. Sirmatel
    • 5
  • S. Unal
    • 6
  • H. Turgut
    • 7
  • D. Ozdemir
    • 8
  • G. Ersoz
    • 9
  • C. Uzun
    • 10
  • S. Ulusoy
    • 11
  • S. Esen
    • 1
  • F. Ulger
    • 1
  • A. Dilek
    • 1
  • H. Yilmaz
    • 1
  • O. Turhan
    • 2
  • N. Gunay
    • 2
  • E. Gumus
    • 2
  • O. Dursun
    • 2
  • G. Yýlmaz
    • 4
  • S. Kaya
    • 4
  • H. Ulusoy
    • 4
  • M. Cengiz
    • 12
  • L. Yilmaz
    • 12
  • G. Yildirim
    • 6
  • A. Topeli
    • 6
  • S. Sacar
    • 7
  • H. Sungurtekin
    • 7
  • D. Uğurcan
    • 7
  • M. F. Geyik
    • 8
  • A. Şahin
    • 8
  • S. Erdogan
    • 8
  • A. Kaya
    • 9
  • N. Kuyucu
    • 9
  • B. Arda
    • 11
  • F. Bacakoglu
    • 11
  1. 1.Ondokuz Mayis University Medical SchoolSamsunTurkey
  2. 2.Akdeniz UniversityAntalyaTurkey
  3. 3.International Nosocomial Infection Control ConsortiumBuenos AiresArgentina
  4. 4.Karadeniz Technical University School of MedicineTrabzonTurkey
  5. 5.Faculty of MedicineAbant Izzet Baysal UniversityBoluTurkey
  6. 6.Hacettepe University School of MedicineAnkaraTurkey
  7. 7.Pamukkale UniversityDenizliTurkey
  8. 8.Duzce University Medical School Infectious Diseases and Clinical MicrobiologyDuzceTurkey
  9. 9.Faculty of MedicineMersin UniversityMersinTurkey
  10. 10.German HospitalIstanbulTurkey
  11. 11.Medical FacultyEge UniversityIzmirTurkey
  12. 12.Faculty of MedicineHarran UniversitySanliurfaTurkey