Trends of Device Utilization Ratios in Intensive Care Units During 10 Years in South Korea: Results from the Korean National Healthcare-Associated Infections Surveillance System

BACKGROUND: Device-associated healthcare-associated infection (DA-HAI) is an important issue related to safety of patients. It is important to reduce unnecessary device utilization in order to decrease DA-HAI rates. Therefore, we investigate to the time trend of device utilization (DU) ratios and DA-HAI rates to analyzed collected data for 10 years through the Korean National Healthcare-associated Infections Surveillance System (KONIS) which is voluntarily participating in hospitals. METHODS: We investigate the time trend of DU ratios and DA-HAI rates from 2006 through 2015 in KONIS participating intensive care units (ICUs). DA-HAI rates were calculated as the numbers of infections per 1,000 device-days and DU were calculated as a ratio of device-days to patient-days. The pooled incidences of DAIs and DU ratios were calculated for each year of participation. RESULTS: Data were collected on 5,325,176 catheter-days and 6,358,829 patient-days in the 190 participating ICUs between July 2006 and June 2016. From 2006 to 2015, year-wise ventilator utilization ratio (V-UR) per 1000 patients-days increased significantly from 0.40 to 0.454 (F = 6.27, P < 0.0001), year-wise urinary catheter utilization ratio (UC-UR) show gradually increased trend from 0.83 to 0.84 but non-significantly (F = 1.66, P = 0.0951), and year-wise c-line utilization ratio (CL-UR) was gradually decreased non-significantly from 0.55 to 0.52 (F = 1.62, P = 0.1059). In subgroup analysis, Medical ICU (F = 2.79, P = 0.0034) or hospital with more than 900 beds (F = 3.07, P = 0.0015) related to increased significantly V-UR. Rate of ventilator associated pneumonia significantly decreased from 3.48 in 2006 to 1.00 in 2015 (per 1000 ventilator-days, F = 27.62, P < 0.0001). Also, rates of catheter associated UTI and c-line associated blood stream infection significantly decreased from 1.85 to 0.88 (per 1000 catheter-days, F = 10.14, P < 0.0001) and from 3.40 to 2.20 (per 1000 catheter-days, F = 14.17, P < 0.0001). CONCLUSION: In Korea, all of the DA-HAIs have shown a significant reduction in the last 10 years, however V-UR has year-wise significantly increased trend for past 10-years, also UC-UR and CL-UR have not decreased trend significantly. We need effort to make reduction of device utilization ratios. DISCLOSURES: E. J. Kim, Korean Nosocomial Infections Surveillance System (KONIS): Investigator, Research support; Y. HOURS. Choi, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; H. Y. Kim, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; Y. G. Kwak, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; T. H. Kim, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; H. B. Kim, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; S. H. Park, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; M. Lee, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; S. O. Lee, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; J. Y. Choi, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; P. G. Choe, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; S. K. Lim, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research grant; S. R. Kim, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; M. J. Shin, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; S. Y. Yoo, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; H. Yoo, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; J. Y. Choi, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support; S. H. Han, Korean Nosocomial Infections Surveillance System (KONIS): Board Member, Research support