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1.  Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC) 
Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey.
We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention.
During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB.
The implementation of multidimensional infection control approach was associated with a significant reduction in the CLAB rates in adult ICUs of Turkey, and thus should be widely implemented.
PMCID: PMC3674978  PMID: 23641950
Catheter related infections; Central line-associated bloodstream infection; Device-associated infections; Healthcare-associated infections; Bundle; International nosocomial infection control consortium; Multidimensional approach; Hand hygiene; Developing countries; Limited-resource countries
3.  Are we aware how contaminated our mobile phones with nosocomial pathogens? 
The objective of this study was to determine the contamination rate of the healthcare workers' (HCWs') mobile phones and hands in operating room and ICU. Microorganisms from HCWs' hands could be transferred to the surfaces of the mobile phones during their use.
200 HCWs were screened; samples from the hands of 200 participants and 200 mobile phones were cultured.
In total, 94.5% of phones demonstrated evidence of bacterial contamination with different types of bacteria. The gram negative strains were isolated from mobile phones of 31.3% and the ceftazidime resistant strains from the hands were 39.5%. S. aureus strains isolated from mobile phones of 52% and those strains isolated from hands of 37.7% were methicillin resistant. Distributions of the isolated microorganisms from mobile phones were similar to hands isolates. Some mobile phones were contaminated with nosocomial important pathogens.
These results showed that HCWs' hands and their mobile phones were contaminated with various types of microorganisms. Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals.
PMCID: PMC2655280  PMID: 19267892

Results 1-3 (3)