Table I.
Key elements of national IPC core components and a comparison according to the World Bank country income level classification
| National IPC core components | All countries | Comparison between World Bank income levels |
P-value | |||
|---|---|---|---|---|---|---|
| High income | Upper-middle income | Lower-middle income | Low income | |||
| Details of selected core components | N = 88 | N = 30 | N = 21 | N = 17 | N = 20 | |
| Guideline implementation strategy | 32 (36.4%) | 17 (56.7%) | 6 (28.6%) | 5 (29.4%) | 4 (20%) | 0.04 |
| Monitoring guideline compliance | 19 (21.6%) | 11 (36.7%) | 5 (23.8%) | 2 (11.8%) | 1 (5%) | 0.04 |
| Master level training in IPC | 16 (18.2%) | 10 (33.3%) | 5 (23.8%) | 1 (5.9%) | 0 | <0.01 |
| Doctoral training in IPC | 8 (9.1%) | 6 (20%) | 2 (9.5%) | 0 | 0 | <0.05 |
| National reference laboratory for HCAIs and AMR | 65 (73.9%) | 28 (93.3%) | 16 (76.2%) | 12 (70.6%) | 9 (45%) | 0.01 |
| Understanding of MMIS | 45 (51.1%) | 18 (60%) | 12 (57.1%) | 8 (47%) | 7 (35%) | 0.33 |
| Monitoring indicators | N = 58 | N = 22 | N = 12 | N = 10 | N = 14 | |
| Hand hygiene compliance | 29 (50%) | 14 (63.6%) | 6 (50%) | 4 (40%) | 5 (35.7%) | 0.38 |
| Alcohol-based hand-rub consumption | 16 (27.6%) | 9 (40.9%) | 4 (33.3%) | 1 (10%) | 2 (14.3%) | 0.19 |
| WASH indicators | 34 (58.6%) | 3 (13.6%) | 8 (66.7%) | 9 (90%) | 14 (100%) | <0.01 |
| Antibiotic consumption | 23 (39.7%) | 13 (59.1%) | 6 (50%) | 2 (20%) | 2 (14.3%) | 0.025 |
| Healthcare worker staffing levels | 14 (24.1%) | 6 (27.3%) | 5 (41.7%) | 2 (20%) | 1 (7.1%) | 0.22 |
| Bed occupancy | 21 (36.2%) | 10 (45.5%) | 7 (58.3%) | 2 (20%) | 2 (14.3%) | 0.06 |
| Other | 7 (12.1%) | 6 (27.3%) | 0 | 1 (10%) | 0 | 0.04 |
| HCAI surveillance | N = 41 | N = 25 | N = 13 | N = 3 | N = 0 | |
| CAUTI | 28 (68.3%) | 14 (56%) | 13 (100%) | 1 (33.3%) | 0 | <0.01 |
| HAP/VAP | 24 (58.5%) | 13 (52%) | 11 (84.6%) | 0 | 0 | <0.01 |
| CLABSI | 31 (75.6%) | 17 (68%) | 13 (100%) | 1 (33.3%) | 0 | <0.01 |
| SSI | 34 (82.9%) | 22 (88%) | 11 (84.6%) | 1 (33.3%) | 0 | 0.14 |
| AMR surveillance | N = 41 | N = 25 | N = 13 | N = 3 | N = 0 | |
| Clostridioides difficile infection | 21 (51.2%) | 16 (64%) | 4 (30.8%) | 1 (33.3%) | 0 | 0.14 |
| MRSA | 34 (82.9%) | 21 (84%) | 11 (84.6%) | 2 (66.7%) | 0 | 0.65 |
| CRE, CRAB and/or CRPsA | 28 (68.3%) | 16 (64%) | 11 (84.6%) | 1 (33.3%) | 0 | 0.16 |
| ESBL-producing Enterobacterales | 19 (46.3%) | 12 (48%) | 6 (46.2%) | 1 (33.3%) | 0 | 1 |
IPC, infection prevention and control; HCAI, healthcare-associated infection; AMR, antimicrobial resistance; MMIS, multi-modal improvement strategy; WASH, water sanitation and hygiene; CAUTI, catheter-associated urinary tract infection; HAP/VAP, healthcare/ventilator-associated pneumonia; CLABSI, central-line-associated bloodstream infection; SSI, surgical site infection; MRSA, meticillin-resistant Staphylococcus aureus; CRE, carbapenem-resistant Enterobacterales; CRAB, carbapenem-resistant Acinetobacter baumannii; CRPsA, carbapenem-resistant Pseudomonas aeruginosa.