Morbidity, mortality, and emerging drug resistance in Device-associated infections (DAIs) in intensive care patients at a 1000-bedded tertiary care teaching hospital.

Autor: Khan ID; Associate Professor (Microbiology), Army College of Medical Sciences & Base Hospital, Delhi Cantt, India., Gonimadatala G; Army College of Medical Sciences, Delhi Cantt, India., Narayanan S; Classified Specialist (Respiratory Medicine), Military Hospital Dehradun, India., Kapoor U; Senior Advisor & Head (Pathology), Military Hospital Jaipur, Rajasthan, India., Kaur H; Graded Specialist (Microbiology), Command Hospital (Northern Command), Udhampur, India., Makkar A; Deputy Dean & Professor (Microbiology), Army College of Medical Sciences & Base Hospital, Delhi Cantt, India., Gupta RM; MG (Med), HQ Western Command, India.
Jazyk: angličtina
Zdroj: Medical journal, Armed Forces India [Med J Armed Forces India] 2022 Apr; Vol. 78 (2), pp. 221-231. Date of Electronic Publication: 2021 Oct 28.
DOI: 10.1016/j.mjafi.2021.06.031
Abstrakt: Background: Device-associated infections (DAIs) such as ventilator associated pneumonia (VAP), central line-associated blood stream infection (CLABSI), and catheter-related urinary tract infection (CAUTI) are principal contributors to health hazard and a major preventable threat to patient safety. Robust surveillance of DAI delineates infections, pathogens, resistograms, and facilitates antimicrobial therapy, infection-control, antimicrobial stewardship, and improvement in quality of care.
Methods: This prospective outcome surveillance study was conducted amongst 2067 ICU patients in a 1000-bedded teaching hospital. Clinical, laboratory, and environmental surveillance, as well as screening of health care professionals (HCPs) were conducted using the modified US Centers for Disease Control and Prevention-National Healthcare Safety Network definitions and methods. Morbidity, mortality, and health-care indices were analyzed and two-tier infection prevention and control was promulgated.
Results: Mean occupancy was 95.34% for 2061 patients of 7381 patients/bed/ICU days. One hundred seventeen episodes of DAI occurred in 1258 patients of 12,882 device-days with mean device utilization ratio of 1.79. Mean rate of DAI was 7.40 per 1000 device days. Multiresistant Pseudomonas aeruginosa was most commonly followed by Acinetobacter. Mean all-cause mortality in ICU was 24.85%, whereas all-cause mortality after DAI was 9.79%. Methicillin-resistant Staphylococcus aureus prevalence was 38.46% amongst health-care professionals.
Conclusion: Mean rates of VAP, CLABSI, and CAUTI were 20.69, 2.53, and 2.23 per 1000 device days comparable with Indian and global ICUs. Resolute conviction and sustained momentum in infection prevention and control is an essential step toward patient safety.
Competing Interests: The authors have none to declare.
(© 2022 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)
Databáze: MEDLINE
Externí odkaz: