An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)

Abstract

Background: Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied. Methods: International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used. Results: In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040). The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%. Conclusions: Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.

Vascular catheter-related infections: an endemic disease in healthcare institutions. An opinion paper of the Spanish Society of Cardiovascular Infections (SEICAV)

“…According to data from studies of the evolution of the etiology of CR-BSI, the distribution of microorganisms has fluctuated over the years, with variations according to country or type of catheter [5,6]. Specifically, in a recent study carried out in 100 ICUs in 9 Latin American countries, it has been reported that the rates of Gram-positive and Gram-negative bacteria have been equalized with a rate of 48.5% [7]. However, these trends can be affected by different events, as was the case in the COVID-19 pandemic, where the rates of C-RBSI/1,000 admissions increased significantly compared to previous years, with CoNS being the major causative agent [8].…”

Management actions for prevention and control of healthcare‐associated infections: A grounded theory approach

“…Although hospital institutions are required to set up HAI control committees, some professional teams are not qualified for this function or are overloaded with health assistance (Nogueira Junior et al, 2014). The HAI rates were higher in Latin American countries when compared with studies carried out in economically developed countries, showing that those with limited resources have losses in terms of patient safety (Rosenthal et al, 2021). Prevention of nosocomial infections has in essence an evidence‐based practice, but not all institutions are successful in implementing prevention methodology, which can be explained partly by the variability of hospital management actions (McAlearney et al, 2021).…”

Peripheral vascular catheter use in Latin America (the vascular study): A multinational cross-sectional study

“…Information about PIVC use in patients admitted to Latin American hospitals is scarce and has limited focus, such as infection only ( 11 ) or a predominance of top-tier facilities in major population centers ( 1 ), which may not be reflective of the large diversity within these nations. Despite individual studies/hospital reports indicating PIVC complications are common, limited data examines why these complications occur.…”

“…Although the evidence on vascular access devices is rapidly expanding, as evidenced by international studies ( 1 , 11 , 12 ), much of the data comes from high income countries whose health services are supported by significant allocation of their total national expenditure. The World Health Organization cites the limited allocation of funding to healthcare in low and middle-income regions, including Latin America, as a contributing factor to the high mortality rate related to nosocomial infections, estimated to be 20 times higher than in high income countries ( 13 ).…”