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Kwak, Choi, Yoo, Lee, Kim, Han, Choi, Kim, Kim, Kim, Lee, Chun, Kim, Eun, Koo, Cho, Uh, and Lee: Korean National Healthcare-associated Infections Surveillance System, Intensive Care Unit Module Report: Summary of Data from July 2014 through June 2015
Original Article

Korean J Healthc Assoc Infect Control Prev 2016;21(2):37-49.

Published online: 19 December 2016

DOI: https://doi.org/10.14192/kjhaicp.2016.21.2.37

Korean National Healthcare-associated Infections Surveillance System, Intensive Care Unit Module Report: Summary of Data from July 2014 through June 2015

Yee Gyung Kwak1, Jun Yong Choi2, Hyeonmi Yoo3, Sang-Oh Lee4, Hong Bin Kim5, Su Ha Han6, Hee Jung Choi7, Hyo Youl Kim8, Sung Ran Kim9, Tae Hyong Kim10, Hyukmin Lee11, Hee Kyung Chun12, Jae-Seok Kim13, Byung Wook Eun14, Hyun-Sook Koo15, En-Hi Cho15, Young Uh16, Kyungwon Lee11

1Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea

2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

3Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, Korea

4Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

5Department of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam, Korea

6Department of Infection Prevention and Control, Soonchunhyang University Bucheon Hospital, Bucheon, Korea

7Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea

8Department of Internal Medicine, Wonju Severance Christian Hospital, Wonju, Korea

9Infection Control Office, Korea University Guro Hospital, Seoul, Korea

10Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea

11Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea

12Department of Infection Control, Kyunghee University Hospital, Seoul, Korea

13Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea

14Department of Pediatrics, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea

15Division of Infectious Disease Control, Korea Centers for Disease Control and Prevention, Osong, Korea

16Department of Laboratory Medicine, Wonju Severance Christian Hospital, Wonju, Korea

Correspondence to: Jun Yong Choi, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei- ro, Seodaemun-gu, Seoul 03722, Korea Tel: 02-2228-1974, Fax: 02-393-6884 E-mail: seran@yuhs.ac

Received 31 May 2016       Revised 11 August 2016       Accepted 1 September 2016

Copyright © 2016 Korean Society for Healthcare-associated Infection Control and Prevention

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

In this report, we present annual data of the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2014 through June 2015.

Methods

We performed prospective surveillance of nosocomial urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia (PNEU) cases at 169 ICUs in 96 hospitals using the KONIS surveillance system. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days.

Results

A total of 2,524 NIs were found during the study period: 699 UTIs (675 cases were urinary catheter-associated), 1,090 BSIs (932 were central line-associated), and 735 PNEUs (443 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 0.91 cases per 1,000 device-days (95% confidence interval, 0.84-0.98), and the urinary catheter utilization ratio was 0.84 (0.839-0.841). The rate of central line-associated BSIs (CLABSI) was 2.04 (1.91-2.17), and the utilization ratio was 0.52 (0.519-0.521). The rate of ventilator-associated PNEUs was 1.23 (1.12-1.35), and the utilization ratio was 0.41 (0.409-0.411). The urinary catheter utilization ratio was lower; however, CAUTIs were more common in the ICUs of hospitals with 300-699 beds than in the ICUs of hospitals with more than 900 beds.

Conclusion

BSIs were the most commonly reported NIs. The rates of CAUTI and CLABSI were lower in this study period than during the previous period (July 2013 through June 2014).

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Keywords: Intensive care unit, KONIS, Korean Nosocomial Infections Surveillance System, Nosocomial infection

kjhaicp-2016-21-2-37f1.tif
Figure 1.
Antimicrobial resistance rates of major pathogens isolated from patients with nosocomial infections during 8-year period (MRSA, methicillin-resistant Staphylococcus aureus; VREFA, vancomycin-resistant Enterococcus faecalis; VREFM, vancomycin-resistant Enterococcus faecium; CTX-R EC, cefotaxime-resistant Escherichia coli; CTX-R KP, cefotaxime-resistant Klebsiella pneumoniae; CIP-R EC, ciprofloxacin-resistant Escherichia coli; CIP-R KP, ciprofloxacin-resistant Klebsiella pneumoniae; IRAP, imiepenem-resistant Pseudomonas aeruginosa; IRAB, imipenem-resistant Acinetobacter baumannii).

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kjhaicp-2016-21-2-37f2.tif
Figure 2.
Catheter-related bloodstream infection (CABSI) and ventilator-associated pneumonia (VAP) rate during 8-year period since 1st KONIS annual report (error bars represent 95% confidence interval).

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Table 1.
Characteristics of hospitals and intensive care units participated in KONIS from July 2014 through June 2015
Variables Number (%)
Characteristics of hospitals
 Total no. of hospitals 96
  No. of university-affiliated hospitals 67 (69.8)
  No. of major teaching hospitals 71 (73.4)
  No. of private hospitals 76 (79.2)
 Average no. of beds 769
 Beds size
  ≥900 20 (20.8)
  700-899 33 (34.4)
  300-699 43 (44.8)
 Area
  Seoul 29 (30.2)
  Kangwon/Gyeonggi/Incheon 27 (28.1)
  Central/South 40 (41.7)
 Hospitals with special ward
  Hemato-oncology 52 (54.2)
  Bone marrow transplantation 35 (36.5)
  Solid organ transplantation 19 (19.8)
  Hemodialysis 94 (97.9)
 Infectious Diseases Physician per hospital 1.5
 Infection Control Professional per hospital 2.2
 Beds per Infection Control Professional 345
Composition of intensive care units (ICUs)
 Total no. of ICUs 169
  Medical ICU 68 (40.3)
  Medical combined ICU 31 (18.3)
  Surgical combined ICU 23 (13.6)
  Surgical ICU 22 (13.0)
  Neurosurgical ICU 25 (14.8)
 Duration of Surveillance
  3 months 10 (5.9)
  6 months 8 (4.7)
  9 months 4 (2.4)
  12 months 147 (87.0)

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Table 2.
Pooled means of nosocomial infection rates, by number of hospital beds, July 2014 through June 2015
Nosocomial infection rate No. of hospital beds
≥900 700-899 300-699 All
No. of units 41 62 66 169
Patient-days 227,623 349,535 305,980 883,138
Infection rate*
 No. of infections 594 1,090 840 2,524
 Pooled mean 2.61 3.12 2.75 2.86
 95% CI 2.41-2.83 2.94-3.31 2.57-2.94 2.75-2.97
UTI rate†
 No. of UTI 140 283 276 699
 Pooled mean 0.62 0.81 0.90 0.79
 95% CI 0.52-0.73 0.72-0.91 0.80-1.01 0.73-0.85
BSI rate‡
 No. of BSI 310 459 321 1,090
 Pooled mean 1.36 1.31 1.05 1.23
 95% CI 1.22-1.52 1.20-1.44 0.94-1.17 1.16-1.31
PNEU rate§
 No. of PNEU 144 348 243 735
 Pooled mean 0.63 1.00 0.79 0.83
 95% CI 0.54-0.74 0.90-1.11 0.70-0.90 0.77-0.89

* (No. of UTIs, BSIs, or PNEUs/No. of patient-days)×1,000;

† (No. of UTIs/No. of patient-days)×1,000;

‡ (No. of BSIs/No. of patient-days)×1,000;

§ (No. of PNEUs/No. of patient-days)×1,000.

Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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Table 3.
Pooled means and percentiles of the device-associated infection rates, by number of hospital beds, July 2014 through June 2015
No. of hospital beds No. of units No. of infection Device days Pooled mean 95% CI 10‰ 25‰ 50‰ 75‰ 90‰
Urinary catheter-associated UTI rate*
 ≥900 41 134 193,951 0.69 0.58-0.82 0 0 0.45 0.67 2.87
 700-899 62 276 304,684 0.91 0.81-1.02 0 0.20 0.51 1.28 2.12
 300-699 66 265 247,132 1.07 0.95-1.21 0 0.29 0.74 1.59 2.39
 All 169 675 745,767 0.91 0.84-0.98 0 0.20 0.56 1.34 2.32
Central line-associated BSI rate†
 ≥900 41 278 137,720 2.02 1.79-2.27 0 0.84 1.34 2.86 4.07
 700-899 62 392 193,050 2.03 1.84-2.24 0.42 1.07 1.92 3.02 3.66
 300-699 66 262 127,118 2.06 1.83-2.33 0 0.20 1.49 3.10 4.82
 All 169 932 457,888 2.04 1.91-2.17 0 0.84 1.54 3.01 3.99
Ventilator-associated PNEU rate‡
 ≥900 41 90 103,137 0.87 0.71-1.07 0 0 0.56 1.81 2.64
 700-899 62 234 153,033 1.53 1.35-1.74 0 0.27 1.03 2.03 4.41
 300-699 66 119 103,883 1.15 0.96-1.37 0 0 0.50 1.60 3.87
 All 169 443 360,053 1.23 1.12-1.35 0 0 0.67 1.82 3.89

* (No. of urinary catheter-associated UTIs/No. of urinary catheter-days)×1,000;

† (No. of central line-associated BSIs/No. of central line-days)×1,000;

‡ (No. of ventilator-associated PNEUs/No. of ventilator-days)×1,000.

Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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Table 4.
Pooled means and percentiles of the distribution of device- utilization ratios, by number of hospital beds, July 2014 through June 2015
No. of hospital beds No. of units Device days Patient days Pooled mean 95% CI 10‰ 25‰ 50‰ 75‰ 90‰
Urinary catheter utilization ratio*
 ≥900 41 193,951 227,623 0.85 0.849-0.851 0.71 0.81 0.89 0.93 0.97
 700-899 62 304,684 349,535 0.87 0.869-0.871 0.75 0.83 0.90 0.94 0.98
 300-699 66 247,132 305,980 0.81 0.809-0.811 0.63 0.76 0.85 0.91 0.96
 All 169 745,767 883,138 0.84 0.839-0.841 0.69 0.81 0.88 0.93 0.98
Central line utilization ratio†
 ≥900 41 137,720 227,623 0.61 0.608-0.612 0.40 0.50 0.65 0.75 0.85
 700-899 62 193,050 349,535 0.55 0.548-0.552 0.40 0.43 0.53 0.68 0.78
 300-699 66 127,118 305,980 0.42 0.418-0.422 0.25 0.32 0.41 0.51 0.59
 All 169 457,888 883,138 0.52 0.519-0.521 0.30 0.40 0.51 0.64 0.77
Ventilator utilization ratio‡
 ≥900 41 103,137 227,623 0.45 0.448-0.452 0.19 0.29 0.47 0.66 0.76
 700-899 62 153,033 349,535 0.44 0.438-0.442 0.27 0.35 0.42 0.51 0.60
 300-699 66 103,883 305,980 0.34 0.338-0.342 0.15 0.24 0.36 0.45 0.53
 All 169 360,053 883,138 0.41 0.409-0.411 0.19 0.30 0.39 0.51 0.63

* (No. of urinary catheter-days/No. of patient-days);

† (No. of central line-days/No. of patient-days);

‡ (No. of ventilatordays/No. of patient-days).

Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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Table 5.
Pooled means and percentiles of the distribution of device- associated infection rates, by type of ICU, July 2014 through June 2015
Type of ICU No. of units No. of infection Device days Pooled mean 95% CI 10‰ 25‰ 50‰ 75‰ 90‰
Urinary catheter-associated UTI rate*
 MICU 68 261 309,194 0.84 0.75-0.95 0 0 0.38 1.13 2.09
 MCICU 31 122 150,769 0.81 0.68-0.97 0 0.24 0.57 1.28 1.94
 SCICU 23 95 87,684 1.08 0.86-1.33 0 0 0.80 1.59 2.41
 SICU 22 80 88,445 0.91 0.73-1.13 0 0.19 0.50 1.14 1.99
 NSICU 25 117 109,675 1.07 0.89-1.28 0.08 0.27 0.64 2.13 2.66
Central line-associated BSI rate†
 MICU 68 468 201,581 2.32 2.12-2.54 0.22 1.13 2.12 3.39 4.75
 MCICU 31 152 83,413 1.82 1.55-2.14 0 0.27 1.15 3.18 3.96
 SCICU 23 100 55,571 1.80 1.48-2.19 0 0 1.45 2.41 4.27
 SICU 22 133 59,572 2.23 1.88-2.65 0 0.92 1.73 3.10 3.80
 NSICU 25 79 57,751 1.37 1.10-1.71 0 0.61 1.30 2.34 3.25
Ventilator-associated PNEU rate‡
 MICU 68 134 174,117 0.77 0.65-0.91 0 0 0.44 1.10 2.06
 MCICU 31 66 61,650 1.07 0.84-1.36 0 0 0.46 1.37 3.32
 SCICU 23 63 39,684 1.59 1.24-2.03 0 0.50 0.88 1.98 3.81
 SICU 22 75 44,002 1.70 1.36-2.14 0 0 1.33 2.91 5.07
 NSICU 25 105 40,600 2.59 2.14-3.13 0 0.60 1.82 4.76 6.24

* (No. of urinary catheter-associated UTIs/No. of urinary catheter-days)×1,000;

† (No. of central line-associated BSIs/No. of central line-days)×1,000;

‡ (No. of ventilator-associated PNEUs/No. of ventilator-days)×1,000.

Abbreviations: ICU, intensive care unit; MICU, medical ICU; MCICU, medical combined ICU; SCICU, surgical combined ICU; SICU, surgical ICU; NSICU, neurosurgical ICU; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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Table 6.
Pooled means and percentiles of the distribution of device- utilization ratios, by type of ICU, July 2014 through June 2015
Type of ICU No. of units Device days Patient days Pooled mean 95% CI 10‰ 25‰ 50‰ 75‰ 90‰
Urinary catheter utilization ratio*
 MICU 68 309,194 377,167 0.82 0.819-0.821 0.67 0.78 0.83 0.90 0.95
 MCICU 31 150,769 176,191 0.86 0.858-0.862 0.73 0.83 0.87 0.92 0.96
 SCICU 23 87,684 103,223 0.85 0.848-0.852 0.59 0.77 0.91 0.95 0.99
 SICU 22 88,445 102,978 0.86 0.858-0.862 0.81 0.85 0.89 0.94 0.96
 NSICU 25 109,675 123,579 0.89 0.888-0.892 0.72 0.86 0.93 0.98 0.99
Central line utilization ratio†
 MICU 68 201,581 377,167 0.53 0.528-0.532 0.32 0.40 0.53 0.64 0.79
 MCICU 31 83,413 176,191 0.47 0.468-0.472 0.26 0.34 0.45 0.53 0.77
 SCICU 23 55,571 103,223 0.54 0.537-0.543 0.31 0.43 0.53 0.66 0.75
 SICU 22 59,572 102,978 0.58 0.577-0.583 0.28 0.45 0.63 0.73 0.83
 NSICU 25 57,751 123,579 0.47 0.467-0.473 0.35 0.41 0.45 0.52 0.66
Ventilator utilization ratio‡
 MICU 68 174,117 377,167 0.46 0.458-0.462 0.28 0.37 0.45 0.58 0.69
 MCICU 31 61,650 176,191 0.35 0.348-0.352 0.10 0.20 0.41 0.47 0.55
 SCICU 23 39,684 103,223 0.38 0.377-0.383 0.21 0.28 0.37 0.42 0.55
 SICU 22 44,002 102,978 0.43 0.427-0.433 0.16 0.28 0.38 0.48 0.67
 NSICU 25 40,600 123,579 0.33 0.327-0.333 0.14 0.21 0.31 0.44 0.60

* (No. of urinary catheter-days/No. of patient-days);

† (No. of central line-days/No. of patient-days);

‡ (No. of ventilatordays/No. of patient-days).

Abbreviations: ICU, intensive care unit; MICU, medical ICU; MCICU, medical combined ICU; SCICU, surgical combined ICU; SICU, surgical ICU; NSICU, neurosurgical ICU; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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Table 7.
Number (%) of microorganisms isolated from clinical specimens of patients with nosocomial infections
Organisms No. of isolates
SUTI ABUTI UTI BSI PNEU3 PNEU2 PNEU1 PNEU All
Gram-positive cocci (%) 180 (25.3) 7 (31.8) 187 (25.5) 549 (48.4) 0 (0) 16 (34.0) 166 (29.9) 182 (30.2) 918 (37.2)
 Staphylococcus aureus 9 0 9 156 0 14 134 148 313
 Coagulase-negative staphylococci 14 1 15 136 0 0 2 2 153
 Streptococcus pneumoniae 0 0 0 0 0 0 7 7 7
 Streptococcus species 2 0 2 4 0 1 20 21 27
 Enterococcus faecalis 68 0 68 88 0 0 1 1 157
 Enterococcus faecium 87 6 93 154 0 0 1 1 248
 Enterococcus species 0 0 0 9 0 0 0 0 9
 Others 0 0 0 2 0 1 1 2 4
Gram-positive bacilli (%) 3 (0.4) 0 (0) 3 (0.4) 10 (0.9) 0 (0) 0 (0) 0 (0) 0 (0) 13 (0.5)
 Listeria monocytogenes 0 0 0 1 0 0 0 0 1
 Corynebacterium species 3 0 3 7 0 0 0 0 10
 Others 0 0 0 2 0 0 0 0 2
Gram-negative bacilli (%) 320 (45.0) 6 (27.3) 326 (44.5) 383 (33.8) 1 (100) 29 (61.7) 382 (68.8) 412 (68.3) 1,121 (45.4)
 Escherichia coli 118 3 121 20 0 0 6 6 147
 Klebsiella pneumoniae 66 1 67 58 0 7 67 74 199
 Klebsiella species 3 0 3 2 0 1 3 4 9
 Enterobacter cloacae 9 0 9 14 0 2 14 16 39
 Enterobacter aerogenes 5 0 5 4 0 0 19 19 28
 Enterobacter species 0 0 0 0 0 0 1 1 1
 Serratia marcescens 9 0 9 15 0 0 5 5 29
 Serratia species 0 0 0 0 0 0 1 1 1
 Proteus mirabilis 16 0 16 4 0 0 1 1 21
 Proteus species 3 1 4 0 0 0 0 0 4
 Citrobacter freundii 1 0 1 0 0 0 2 2 3
 Citrobacter species 3 0 3 1 0 0 1 1 5
 Morganella morganii 2 0 2 1 0 0 0 0 3
 Pseudomonas aeruginosa 55 1 56 23 0 0 44 44 123
 Pseudomonas species 0 0 0 0 0 0 1 1 1
 Acinetobacter baumannii 25 0 25 163 1 19 199 219 407
 Acinetobacter species 1 0 1 9 0 0 2 2 12
 Burkholderia cepacia 2 0 2 16 0 0 2 2 20
 Burkholderia species 0 0 0 2 0 0 0 0 2
 Stenotrophomonas maltophilia 1 0 1 32 0 0 13 13 46
 Sphingomonas species 0 0 0 3 0 0 0 0 3
 Chryseobacterium species 0 0 0 11 0 0 0 0 11
 Others 1 0 1 5 0 0 1 1 7
Anaerobes (%) 0 (0) 0 (0) 0 (0) 11 (1.0) 0 (0) 0 (0) 0 (0) 0 (0) 11 (0.4)
 Actinomyces species 0 0 0 2 0 0 0 0 2
 Peptostreptococcus species 0 0 0 2 0 0 0 0 2
 Prevotella species 0 0 0 2 0 0 0 0 2
 Clostiridium species 0 0 0 3 0 0 0 0 3
 Others 0 0 0 2 0 0 0 0 2
Fungi (%) 208 (29.3) 9 (40.9) 217 (29.6) 181 (15.9) 0 (0) 2 (4.3) 7 (1.3) 9 (1.5) 407 (16.5)
 Candida albicans 93 4 97 61 0 2 3 5 163
 Candida tropicalis 48 4 52 32 0 0 0 0 84
 Candida glabrata 23 1 24 35 0 0 0 0 59
 Candida parapsilosis 9 0 9 38 0 0 0 0 47
 Candida species 26 0 26 10 0 0 1 1 37
 Trichosporon asahii 4 0 4 3 0 0 0 0 7
 Yeast 5 0 5 2 0 0 2 2 9
 Aspergillus species 0 0 0 0 0 0 1 1 1
Total 711 22 733 1,134 1 47 555 603 2,470

Abbreviations: SUTI, symptomatic urinary tract infection; ABUTI, asymptomatic bacteremic urinary tract infection; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia.

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Table 8.
Susceptibilities of major pathogens isolated from patients with nosocomial infections
Organisms No. of resistant/total isolates (%)
Methicillin-resistant 269/313 (85.9)
 Staphylococcus aureus
Vancomycin-resistant 7/157 (4.5)
 Enterococcus faecalis
Vancomycin-resistant 127/248 (51.2)
 Enterococcus faecium
Cefotaxime-resistant 70/147 (47.6)
 Escherichia coli
Cefotaxime-resistant 112/199 (56.3)
 Klebsiella pneumoniae
Ciprofloxacin-resistant 79/147 (53.7)
 Escherichia coli
Ciprofloxacin-resistant 99/199 (49.7)
 Klebsiella pneumoniae
Imipenem-resistant 53/123 (43.1)
 Pseudomonas aeruginosa
Imipenem-resistant 364/407 (89.4)
 Acinetobacter baumannii

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Table 9.
Comparison of the device utilization ratios and the rates of device-associated infections from 2010 through 2015
Parameter July 2010-June 2011 July 2011-June 2012 July 2012-June 2013 July 2013-June 2014 July 2014-June 2015
No. of hospitals 72 81 91 94 96
No. of units 130 143 161 166 169
Patient-days 585,325 698,595 867,683 832,428 883,138
Device-days
  Urinary catheter-days 503,365 590,793 679,076 701,932 745,767
Central line-days 309,500 362,576 426,783 437,456 457,888
Ventilator-days 233,640 282,472 321,601 340,075 360,053
No. of infections
Urinary catheter-associated UTI 1,949 1,366 854 846 675
Central line-associated BSI 932 1,091 1,096 1,021 932
Ventilator-associated PNEU 410 481 526 498 443
Device utilization ratio (95% CI) [range*]
Urinary catheter 0.86 0.85 0.78 0.84 0.84
(0.859-0.861) (0.849-0.851) (0.779-0.781) (0.839-0.841) (0.839-0.841)
[0.73-0.97] [0.71-0.97] [0.70-0.98] [0.71-0.97] [0.69-0.98]
Central line 0.53 0.52 0.49 0.53 0.52
(0.529-0.531) (0.519-0.521) (0.489-0.491) (0.529-0.531) (0.519-0.521)
[0.31-0.81] [0.30-0.79] [0.29-0.80] [0.29-0.79] [0.30-0.77]
Ventilator 0.40 0.40 0.37 0.41 0.41
(0.399-0.401) (0.399-0.401) (0.369-0.371) (0.409-0.411) (0.409-0.411)
[0.19-0.61] [0.20-0.65] [0.17-0.66] [0.21-0.62] [0.19-0.63]
Rate per 1,000 device-days (95% CI) [range*]
Urinary catheter-associated UTI 3.87 2.26 1.26 1.21 0.91
(3.70-4.05) (2.14-2.39) (1.18-1.34) (1.13-1.29) (0.84-0.98)
[0-8.80] [0-5.61] [0-4.08] [0-2.71] [0-2.32]
Central line-associated BSI 3.01 3.01 2.57 2.33 2.04
(2.82-3.21) (2.84-3.19) (2.42-2.72) (2.20-2.48) (1.91-2.17)
[0-6.92] [0-6.64] [0-7.35] [0-5.08] [0-3.99]
Ventilator-associated PNEU 1.75 1.70 1.64 1.46 1.23
(1.59-1.93) (1.56-1.86) (1.50-1.78) (1.34-1.60) (1.12-1.35)
[0-5.88] [0-5.96] [0-6.67] [0-3.93] [0-3.89]

* 10th to 90th percentile range.

Abbreviations: ICU, intensive care unit; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.

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REFERENCES

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