• Hakan Leblebicioglu, Gulden Ersoz, Victor Daniel Rosenthal, Ata Nevzat Yalcin, Ozay Arıkan Akan, Fatma Sirmatel, Huseyin Turgut, Davut Ozdemir, Emine Alp, Cengiz Uzun, Sercan Ulusoy, Saban Esen, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Ali Kaya, Necdet Kuyucu, Ozge Turhan, Nurgul Gunay, Eylul Gumus, Oguz Dursun, Melek Tulunay, Mehmet Oral, Necmettin Unal, Mustafa Cengiz, Leyla Yilmaz, Suzan Sacar, Hülya Sungurtekin, Doğaç Uğurcan, Mehmet Faruk Geyik, Ahmet Sahin, Selvi Erdogan, Bilgehan Aygen, Bilgin Arda, and Feza Bacakoglu.
• Ondokuz Mayis University Medical School, Samsun, Turkey.
• Am J Infect Control. 2013 Oct 1;41(10):885-91.

BackgroundWe evaluate the effectiveness of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infections (CAUTIs) in 13 intensive care units (ICUs) in 10 hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of Turkey.MethodsA before-after prospective active surveillance study was used to determine rates of CAUTI. The study was divided into baseline (phase 1) and intervention (phase 2). In phase 1, surveillance was performed applying the definitions of the Centers for Disease Control and Prevention/National Healthcare Safety Network. In phase 2, we implemented a multidimensional approach that included bundle of infection control interventions, education, surveillance and feedback on CAUTI rates, process surveillance, and performance feedback. We used random effects Poisson regression to account for clustering of CAUTI rates across time periods.ResultsThe study included 4,231 patients, hospitalized in 13 ICUs, in 10 hospitals, in 10 cities, during 49,644 patient-days. We recorded a total of 41,871 urinary catheter (UC)-days: 5,080 in phase 1 and 36,791 in phase 2. During phase 1, the rate of CAUTI was 10.63 per 1,000 UC-days and was significantly decreased by 47% in phase 2 to 5.65 per 1,000 UC-days (relative risk, 0.53; 95% confidence interval: 0.4-0.7; P value = .0001).ConclusionOur multidimensional approach was associated with a significant reduction in the rates of CAUTI in Turkey.Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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