• Victor D Rosenthal, Carlos Álvarez-Moreno, Wilmer Villamil-Gómez, Sanjeev Singh, Bala Ramachandran, Josephine A Navoa-Ng, Lourdes Dueñas, Ata N Yalcin, Gulden Ersoz, Antonio Menco, Patrick Arrieta, Ana C Bran-de Casares, Lilian de Jesus Machuca, Kavitha Radhakrishnan, Victoria D Villanueva, Maria C V Tolentino, Ozge Turhan, Sevim Keskin, Eylul Gumus, Oguz Dursun, Ali Kaya, and Necdet Kuyucu.
• International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
• Am J Infect Control. 2012 Aug 1;40(6):497-501.

BackgroundVentilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries.MethodsThis was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology.ResultsDuring the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate.ConclusionsOur results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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