Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).

e26014th International Congress on Infectious Diseases (ICID) Abstracts four percent (12/49) of patients received inappropriate initial antibiotics and 83% (10/12) of these were patients who had RGN. Mortality trended higher in patients with RGN infection compared to other GN bacilli (3/10, 30% vs. 3/39, 7.7%; p = 0.06).Conclusion: Most patients diagnosed with GN-CRBSI did not meet our strict criteria for diagnosis, a fact that suggests that GN-CRBSI is misdiagnosed. However, the true diagnosis of GN-CRBSI does not clearly impact mortality or median length of stay. There was a nonsignificant trend towards increased mortality in patients with RGN infection. Antibiotics active against RGN should be considered as part of initial empiric coverage.