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Abstract

Background

Central line-associated bloodstream infection (CLABSI) is among the most common preventable infectious complications in patients in intensive care units (ICU). In 2011, the Israel National Center for Infection Control initiated a nationwide CLABSI prevention programme.

Aim

To evaluate the impact of different components of the programme on CLABSI and non-CLABSI rates in medical-surgical ICUs.

Methods

We included data collected from all 29 medical-surgical ICUs in Israel from November 2011 to December 2019. The study period was divided into three phases: I (baseline, initial CLABSI prevention guidelines introduced, initial feedback on rates provided), II (initial guidelines widely implemented, surveillance undertaken, feedback continued) and III (after implementation of additional prevention measures). Interrupted time series analysis was used to compare CLABSI and non-CLABSI rates during the three phases.

Results

The pooled mean (SD) incidence of CLABSI per 1,000 central line-days dropped from 7.4 (0.38) in phase I to 2.1 (0.13) in phase III (p < 0.001). The incidence rate ratio (IRR) was 0.63 (95% CI: 0.51–0.79) between phases I and II, and 0.78 (95% CI: 0.59–1.02) between phases II and III. The pooled mean (SD) incidence of non-CLABSI per 1,000 patient-days declined from 5.3 (0.24) in phase I to 3.4 (0.13) in phase III (p < 0.001).

Conclusion

National CLABSI prevention guidelines, surveillance and feedback resulted in significant reductions in CLABSI and non-CLABSI rates. In the wake of further interventions, significant reduction was achieved in ICUs reporting improvement in the uptake of additional prevention measures.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2023-06-22
2024-04-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.25.2200688
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Impact of intensified prevention measures on rates of hospital-acquired bloodstream infection in medical-surgical intensive care units, Israel, 2011 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Debby+Ben-David&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ben-David Debby</a>, <a href="/search?value1=Azza+Vaturi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vaturi Azza</a>, <a href="/search?value1=Liat+Wulffhart&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wulffhart Liat</a>, <a href="/search?value1=Elizabeth+Temkin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Temkin Elizabeth</a>, <a href="/search?value1=Ester+Solter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Solter Ester</a>, <a href="/search?value1=Yehuda+Carmeli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carmeli Yehuda</a>, <a href="/search?value1=Mitchell+J+Schwaber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schwaber Mitchell J</a>, <a href="/search?value1=the+National+HA-BSI+Prevention+Working+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">the National HA-BSI Prevention Working Group</a></span>. Impact of intensified prevention measures on rates of hospital-acquired bloodstream infection in medical-surgical intensive care units, Israel, 2011 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(25):pii=2200688. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.25.2200688" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.25.2200688</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Aug 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 Mar 2023 </span> </p>
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