Epidemiology of device-associated infections in an intensive care unit of a teaching hospital in Nepal: A prospective surveillance study from a developing country

Autor: Basista Prasad Rijal, Shyam Kumar Mishra, Jaya Prasad Singh, Santosh Dahal, Narayan Prasad Parajuli, Bharat Mani Pokhrel, Hari Prasad Kattel, Subhash Prasad Acharya
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
Epidemiology
law.invention
0302 clinical medicine
law
Klebsiella
Health care
Antimicrobial stewardship
Infection control
030212 general & internal medicine
Prospective Studies
Cross Infection
biology
Acinetobacter
Health Policy
Incidence (epidemiology)
Burkholderia cepacia complex
Ventilator-associated pneumonia
virus diseases
Pneumonia
Ventilator-Associated
Bacterial Infections
Middle Aged
Intensive care unit
Intensive Care Units
Infectious Diseases
Urinary Tract Infections
Female
Adult
medicine.medical_specialty
Catheterization
Central Venous
030106 microbiology
Urinary Catheters
03 medical and health sciences
Nepal
Catheterization
Peripheral
medicine
Escherichia coli
Humans
Intensive care medicine
Hospitals
Teaching
Developing Countries
business.industry
Public Health
Environmental and Occupational Health
medicine.disease
biology.organism_classification
Catheter-Related Infections
business
Zdroj: American journal of infection control. 45(9)
ISSN: 1527-3296
Popis: Background Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. Methods A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal. DA-HAIs were identified using the Centers for Disease Control and Prevention definitions, and their rates were expressed as number of DA-HAIs per 1,000 device-days. Results Overall incidence rate of DA-HAIs was 27.3 per 1,000 patient-days occurring in 37.1% of patients. The device utilization ratio for mechanical ventilation, central line catheter, and urinary catheter was 0.83, 0.63, and 0.78, respectively. The rates of VAP, CLABSI, and CAUTI were 21.40, 8.64, and 5.11 per 1,000 device-days, respectively. Acinetobacter spp (32.7%), Klebsiella spp (23.6%), Burkholderia cepacia complex (12.7%), and Escherichia coli (10.9%) were the common bacterial pathogens. Most of the bacterial isolates associated with DA-HAIs were found to be multidrug-resistant. Conclusions Incidence of DA-HAIs in the study intensive care unit was high compared with that of developed countries. Formulation and implementation of standard infection control protocols, active surveillance of DA-HAIs, and antimicrobial stewardship are urgently needed in our country.
Databáze: OpenAIRE
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