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

• Autores: Rosenthal, Victor Daniel, Jin, Zhilin, Valderrama-Beltran, Sandra Liliana, Gualtero, Sandra Milena, Linares, Claudia Yaneth, Aguirre-Avalos, Guadalupe, Mijangos-Méndez, Julio Cesar, Ibarra-Estrada, Miguel Ángel, Jiménez-Alvarez, Luisa Fernanda, Reyes, Lidia Patricia, Alvarez-Moreno, Carlos Arturo, Zuniga-Chavarria, Maria Adelia, Quesada-Mora, Ana Marcela, Gomez, Katherine, Alarcon, Johana, Millan-Oñate, Jose, Aguilar-de-Moros, Daisy, Castaño-Guerrero, Elizabeth, Córdoba, Judith, Sassoe-Gonzalez, Alejandro, Millán-Castillo, Claudia Marisol, Leyva-Xotlanihua, Lissette, Aguilar-Moreno, Lina Alejandra, Bravo-Ojeda, Juan Sebastian, Gutierrez-Tobar, Ivan Felipe, Aleman-Bocanegra, Mary Cruz, Echazarreta-Martínez, Clara Veronica, Flores-Sánchez, Belinda Mireya, Cano-Medina, Yuliana Andrea, Chapeta-Parada, Edwin Giovannny, Gonzalez-Niño, Rafael Antonio, Villegas-Mota, Maria Isabel, Montoya-Malváez, Mildred, Cortés-Vázquez, Miguel Ángel, Medeiros, Eduardo Alexandrino, Fram, Dayana, Vieira-Escudero, Daniela, Dueñas, Lourdes, Carreazo, Nilton Yhuri, Salgado, Estuardo, Yin, Ruijie
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Universidad Peruana de Ciencias Aplicadas
• Repositorio: UPC-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorioacademico.upc.edu.pe:10757/668369
• Enlace del recurso: http://hdl.handle.net/10757/668369
• Nivel de acceso: acceso embargado
• Materia: Bloodstream infection; INICC; Intensive care units; Latin America; PICC; Risk factors; Central line (CL); CL-associated bloodstream infections (CLABSI); Latin-America; Multinational multicenter prospective cohort study; Multiple-logistic regression; Length of stay (LOS); Intensive care unit (ICU); Facility ownership; Femoral and internal-jugular central lines; CLABSI prevention recommendations

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.