Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

Victor Daniel Rosenthal; Zhilin Jin; Sandra Liliana Valderrama-Beltran; Sandra Milena Gualtero; Claudia Yaneth Linares; Guadalupe Aguirre-Avalos; Julio Cesar Mijangos-Méndez; Miguel Ángel Ibarra-Estrada; Luisa Fernanda Jiménez-Alvarez; Lidia Patricia Reyes; Carlos Arturo Alvarez-Moreno; Maria Adelia Zuniga-Chavarria; Ana Marcela Quesada-Mora; Katherine Gomez; Johana Alarcon; Jose Millan-Oñate; Daisy Aguilar-de-Moros; Elizabeth Castaño-Guerrero; Judith Córdoba; Alejandro Sassoe-Gonzalez; Claudia Marisol Millán-Castillo; Lissette Leyva-Xotlanihua; Lina Alejandra Aguilar-Moreno; Juan Sebastian Bravo-Ojeda; Ivan Felipe Gutierrez-Tobar; Mary Cruz Aleman-Bocanegra; Clara Veronica Echazarreta-Martínez; Belinda Mireya Flores-Sánchez; Yuliana Andrea Cano-Medina; Edwin Giovannny Chapeta-Parada; Rafael Antonio Gonzalez-Niño; Maria Isabel Villegas-Mota; Mildred Montoya-Malváez; Miguel Ángel Cortés-Vázquez; Eduardo Alexandrino Medeiros; Dayana Fram; Daniela Vieira-Escudero; Lourdes Dueñas; Nilton Yhuri Carreazo; Estuardo Salgado; Ruijie Yin

doi:10.1016/j.ajic.2023.03.006

Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

Victor Daniel Rosenthal
, Zhilin Jin
, Sandra Liliana Valderrama-Beltran
, Sandra Milena Gualtero
, Claudia Yaneth Linares
, Guadalupe Aguirre-Avalos
, Julio Cesar Mijangos-Méndez
, Miguel Ángel Ibarra-Estrada
, Luisa Fernanda Jiménez-Alvarez
, Lidia Patricia Reyes
, Carlos Arturo Alvarez-Moreno
, Maria Adelia Zuniga-Chavarria
, Ana Marcela Quesada-Mora
, Katherine Gomez
, Johana Alarcon
, Jose Millan-Oñate
, Daisy Aguilar-de-Moros
, Elizabeth Castaño-Guerrero
, Judith Córdoba
, Alejandro Sassoe-Gonzalez

Claudia Marisol Millán-Castillo, Lissette Leyva-Xotlanihua, Lina Alejandra Aguilar-Moreno, Juan Sebastian Bravo-Ojeda, Ivan Felipe Gutierrez-Tobar, Mary Cruz Aleman-Bocanegra, Clara Veronica Echazarreta-Martínez, Belinda Mireya Flores-Sánchez, Yuliana Andrea Cano-Medina, Edwin Giovannny Chapeta-Parada, Rafael Antonio Gonzalez-Niño, Maria Isabel Villegas-Mota, Mildred Montoya-Malváez, Miguel Ángel Cortés-Vázquez, Eduardo Alexandrino Medeiros, Dayana Fram, Daniela Vieira-Escudero, Lourdes Dueñas, Nilton Yhuri Carreazo, Estuardo Salgado, Ruijie Yin

University of Miami Leonard M. Miller School of Medicine
INICC Foundation
Hospital Universitario San Ignacio
Universidad de Guadalajara
Clínica Universitaria Colombia
Hospital Clinica Biblica
Santiago de Cali
Hospital del Niño Dr. José Renán Esquivel
Hospital Regional de Alta Especialidad Ixtapaluca
Colsanitas
Instituto Tecnologico de Estudios Superiores de Monterrey
Instituto del Corazón de Bucaramanga
Instituto Nacional de Perinatologia
Universidade Federal de São Paulo
Hospital Nacional de Nińos Benjamin Bloom
Universidad Peruana de Ciencias Aplicadas
Hospital de Especialidades

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

BACKGROUND: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.

METHODS: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).

RESULTS: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.

CONCLUSIONS: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.

Original language	English
Pages (from-to)	1114-1119
Number of pages	6
Journal	American Journal of Infection Control
Volume	51
Issue number	10
DOIs	https://doi.org/10.1016/j.ajic.2023.03.006
State	Published - Oct 2023
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Bloodstream infection
INICC
Intensive care units
Latin America
PICC
Risk factors

Access to Document

10.1016/j.ajic.2023.03.006

Cite this

Rosenthal, V. D., Jin, Z., Valderrama-Beltran, S. L., Gualtero, S. M., Linares, C. Y., Aguirre-Avalos, G., Mijangos-Méndez, J. C., Ibarra-Estrada, M. Á., Jiménez-Alvarez, L. F., Reyes, L. P., Alvarez-Moreno, C. A., Zuniga-Chavarria, M. A., Quesada-Mora, A. M., Gomez, K., Alarcon, J., Millan-Oñate, J., Aguilar-de-Moros, D., Castaño-Guerrero, E., Córdoba, J., ... Yin, R. (2023). Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries. American Journal of Infection Control, 51(10), 1114-1119. https://doi.org/10.1016/j.ajic.2023.03.006

@article{d0e2192350ff47028c972ab8e6a50dd9,

title = "Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries",

abstract = "BACKGROUND: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.METHODS: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).RESULTS: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3\% daily (aOR=1.03;95\%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4\% per CL-day (aOR=1.04;95\%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95\%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95\%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95\%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95\%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95\%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.CONCLUSIONS: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.",

keywords = "Bloodstream infection, INICC, Intensive care units, Latin America, PICC, Risk factors",

author = "Rosenthal, \{Victor Daniel\} and Zhilin Jin and Valderrama-Beltran, \{Sandra Liliana\} and Gualtero, \{Sandra Milena\} and Linares, \{Claudia Yaneth\} and Guadalupe Aguirre-Avalos and Mijangos-M{\'e}ndez, \{Julio Cesar\} and Ibarra-Estrada, \{Miguel {\'A}ngel\} and Jim{\'e}nez-Alvarez, \{Luisa Fernanda\} and Reyes, \{Lidia Patricia\} and Alvarez-Moreno, \{Carlos Arturo\} and Zuniga-Chavarria, \{Maria Adelia\} and Quesada-Mora, \{Ana Marcela\} and Katherine Gomez and Johana Alarcon and Jose Millan-O{\~n}ate and Daisy Aguilar-de-Moros and Elizabeth Casta{\~n}o-Guerrero and Judith C{\'o}rdoba and Alejandro Sassoe-Gonzalez and Mill{\'a}n-Castillo, \{Claudia Marisol\} and Lissette Leyva-Xotlanihua and Aguilar-Moreno, \{Lina Alejandra\} and Bravo-Ojeda, \{Juan Sebastian\} and Gutierrez-Tobar, \{Ivan Felipe\} and Aleman-Bocanegra, \{Mary Cruz\} and Echazarreta-Mart{\'i}nez, \{Clara Veronica\} and Flores-S{\'a}nchez, \{Belinda Mireya\} and Cano-Medina, \{Yuliana Andrea\} and Chapeta-Parada, \{Edwin Giovannny\} and Gonzalez-Ni{\~n}o, \{Rafael Antonio\} and Villegas-Mota, \{Maria Isabel\} and Mildred Montoya-Malv{\'a}ez and Cort{\'e}s-V{\'a}zquez, \{Miguel {\'A}ngel\} and Medeiros, \{Eduardo Alexandrino\} and Dayana Fram and Daniela Vieira-Escudero and Lourdes Due{\~n}as and Carreazo, \{Nilton Yhuri\} and Estuardo Salgado and Ruijie Yin",

year = "2023",

month = oct,

doi = "10.1016/j.ajic.2023.03.006",

language = "English",

volume = "51",

pages = "1114--1119",

journal = "American Journal of Infection Control",

issn = "0196-6553",

publisher = "Elsevier Inc.",

number = "10",

}

Rosenthal, VD, Jin, Z, Valderrama-Beltran, SL, Gualtero, SM, Linares, CY, Aguirre-Avalos, G, Mijangos-Méndez, JC, Ibarra-Estrada, MÁ, Jiménez-Alvarez, LF, Reyes, LP, Alvarez-Moreno, CA, Zuniga-Chavarria, MA, Quesada-Mora, AM, Gomez, K, Alarcon, J, Millan-Oñate, J, Aguilar-de-Moros, D, Castaño-Guerrero, E, Córdoba, J, Sassoe-Gonzalez, A, Millán-Castillo, CM, Leyva-Xotlanihua, L, Aguilar-Moreno, LA, Bravo-Ojeda, JS, Gutierrez-Tobar, IF, Aleman-Bocanegra, MC, Echazarreta-Martínez, CV, Flores-Sánchez, BM, Cano-Medina, YA, Chapeta-Parada, EG, Gonzalez-Niño, RA, Villegas-Mota, MI, Montoya-Malváez, M, Cortés-Vázquez, MÁ, Medeiros, EA, Fram, D, Vieira-Escudero, D, Dueñas, L, Carreazo, NY, Salgado, E & Yin, R 2023, 'Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries', American Journal of Infection Control, vol. 51, no. 10, pp. 1114-1119. https://doi.org/10.1016/j.ajic.2023.03.006

Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries. / Rosenthal, Victor Daniel; Jin, Zhilin; Valderrama-Beltran, Sandra Liliana et al.
In: American Journal of Infection Control, Vol. 51, No. 10, 10.2023, p. 1114-1119.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

AU - Rosenthal, Victor Daniel

AU - Jin, Zhilin

AU - Valderrama-Beltran, Sandra Liliana

AU - Gualtero, Sandra Milena

AU - Linares, Claudia Yaneth

AU - Aguirre-Avalos, Guadalupe

AU - Mijangos-Méndez, Julio Cesar

AU - Ibarra-Estrada, Miguel Ángel

AU - Jiménez-Alvarez, Luisa Fernanda

AU - Reyes, Lidia Patricia

AU - Alvarez-Moreno, Carlos Arturo

AU - Zuniga-Chavarria, Maria Adelia

AU - Quesada-Mora, Ana Marcela

AU - Gomez, Katherine

AU - Alarcon, Johana

AU - Millan-Oñate, Jose

AU - Aguilar-de-Moros, Daisy

AU - Castaño-Guerrero, Elizabeth

AU - Córdoba, Judith

AU - Sassoe-Gonzalez, Alejandro

AU - Millán-Castillo, Claudia Marisol

AU - Leyva-Xotlanihua, Lissette

AU - Aguilar-Moreno, Lina Alejandra

AU - Bravo-Ojeda, Juan Sebastian

AU - Gutierrez-Tobar, Ivan Felipe

AU - Aleman-Bocanegra, Mary Cruz

AU - Echazarreta-Martínez, Clara Veronica

AU - Flores-Sánchez, Belinda Mireya

AU - Cano-Medina, Yuliana Andrea

AU - Chapeta-Parada, Edwin Giovannny

AU - Gonzalez-Niño, Rafael Antonio

AU - Villegas-Mota, Maria Isabel

AU - Montoya-Malváez, Mildred

AU - Cortés-Vázquez, Miguel Ángel

AU - Medeiros, Eduardo Alexandrino

AU - Fram, Dayana

AU - Vieira-Escudero, Daniela

AU - Dueñas, Lourdes

AU - Carreazo, Nilton Yhuri

AU - Salgado, Estuardo

AU - Yin, Ruijie

PY - 2023/10

Y1 - 2023/10

N2 - BACKGROUND: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.METHODS: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).RESULTS: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.CONCLUSIONS: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.

AB - BACKGROUND: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.METHODS: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).RESULTS: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.CONCLUSIONS: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.

KW - Bloodstream infection

KW - INICC

KW - Intensive care units

KW - Latin America

KW - PICC

KW - Risk factors

UR - https://www.scopus.com/pages/publications/85151623210

U2 - 10.1016/j.ajic.2023.03.006

DO - 10.1016/j.ajic.2023.03.006

M3 - Article

C2 - 36921694

AN - SCOPUS:85151623210

SN - 0196-6553

VL - 51

SP - 1114

EP - 1119

JO - American Journal of Infection Control

JF - American Journal of Infection Control

IS - 10

ER -

Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

Abstract

UN SDGs

Keywords

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