Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings.

BACKGROUND: Short-term peripheral venous catheter-related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available. METHODS: Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS: We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%). CONCLUSIONS: PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

Identification of functional domains affected by developmental exposure to methylmercury: Faroe islands and related studies.

The Faroe Islands study is a prospective study designed to assess the neurological and behavioral consequences of in utero exposure to methylmercury (meHg). Maternal exposure to meHg was through consumption of fish and intermittent higher-level exposure through pilot whale meat, while consumption of pilot whale blubber resulted in maternal exposure to PCBs. Analysis of the neurobehavioral domains affected revealed impairment in attention, memory, and auditory processing, impairment in primary auditory function, and to a lesser extent motor impairment. For four of the eight endpoints affected by meHg exposure atp < .10, impairment was also correlated (p < .10) with in utero PCB exposure as measured by cord tissue PCB levels. Further analyses provide evidence for an independent effect of PCBs and meHg on these endpoints. Cross-sectional studies in a smaller number of children in the Amazon and Madeira by the same group of investigators, in which average meHg maternal hair levels were about twice as high those in the Faroe Islands, identified auditory, visual, and/or motor deficits, with little or no evidence of deficits in attention or memory. However, the results of the cross-sectional studies must be interpreted with caution, due to limited statistical power as well as a lack of opportunity to correlate effects to in utero exposure.