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Boni S, Sartini M, Del Puente F, Adriano G, Blasi Vacca E, Bobbio N, Carbone A, Feasi M, Grasso V, Lattuada M, Nelli M, Oliva M, Parisini A, Prinapori R, Santarsiero MC, Tigano S, Cristina ML, Pontali E. Innovative Approaches to Monitor Central Line Associated Bloodstream Infections (CLABSIs) Bundle Efficacy in Intensive Care Unit (ICU): Role of Device Standardized Infection Rate (dSIR) and Standardized Utilization Ratio (SUR)-An Italian Experience. J Clin Med 2024; 13:396. [PMID: 38256530 PMCID: PMC10816537 DOI: 10.3390/jcm13020396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
In several settings, the COVID-19 pandemic determined a negative impact on the occurrence of healthcare-associated infection, particularly for on central lines associated bloodstream infections (CLABSI). In our setting, we observed a significant increase in CLABSI in our intensive care unit (ICU) during 2020 and 2021 vs. 2018 to 2019. A refresher training activity on central venous catheter (CVC) management bundles was carried out in September-October 2021 for the ICU health staff. We assessed the impact of bundle implementation by means of standardized indicators, such as the Device Utilization Ratio (DUR), in this case, the Central Line Utilization Ratio, the Standardized Utilization Ratio (SUR), and the device Standardized Infection Ratio (dSIR). Standardized ratios for device use and infection ratio were computed using data from 2018 and 2019 as expectation data. After bundle implementation, we observed a significant reduction of dSIR (p < 0.001), which dropped from 3.23 and 2.99 in the 2020-2021 biennium to 1.11 in 2022 (CLABSI in the first quarter only); no more CLABSI were observed afterwards. Standardized ratios proved helpful in identify increasing trends of CLABSI in the ICU and monitoring the impact of a simple effective tool, i.e., training on and implementation of a bundle for CVC management.
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Affiliation(s)
- Silvia Boni
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Marina Sartini
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Giulia Adriano
- Hospital Infection Control Committee, Galliera Hospital, 16128 Genoa, Italy; (G.A.); (M.C.S.)
| | - Elisabetta Blasi Vacca
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Alessio Carbone
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
| | - Marcello Feasi
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Viviana Grasso
- Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, Italy; (V.G.); (M.L.)
| | - Marco Lattuada
- Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, Italy; (V.G.); (M.L.)
| | - Mauro Nelli
- Medical Service Management, Galliera Hospital, 16128 Genoa, Italy;
| | - Martino Oliva
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
| | - Andrea Parisini
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Roberta Prinapori
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | | | - Stefania Tigano
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Maria Luisa Cristina
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
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