Details
Category: Volume 06 Issue 11 November 2018
Hits: 1322

Title: A Prospective Cohort Study on the Infections Associated with Indwelling Medical Devices in a Tertiary Care Hospital in South India

Authors: Dr T.S Sushitha, Prof Dr K.V Suseela

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.16

Abstract

Devices associated infections (DAIs) have major impact on patient morbidity. This study was aimed to evaluate the active prospective surveillance to measure the prevalence of three common DAIs like catheter associated urinary tract infection (CAUTI), ventilator-associated pneumonia (VAP) and intra vascular catheter related bloodstream infection (IV-CRBSI) in different ICUs/wards in a tertiary care centre. Urine was collected by aspiration of the catheter in CAUTI, endotracheal aspirate in VAP, catheter tips and blood samples in IVCRBSI were collected and processed as per the standard microbiological techniques. Descriptive analysis of the data was done and DAI rate was expressed as number of DAI per 1000 device days.  The overall infection rate for CAUTI, VAP, IV-CRBSI were found to be 7.03, 34.84 and 0.47 per 1000 device days, respectively. Major organisms isolated were Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa,. Most of them were multi drug resistant.  High rates of DAIs and antimicrobial resistance require strengthening the infection control, instituting surveillance systems, and implementing evidence-based preventive strategies.

Keywords: Devices associated infections, multi drug resistant, urinary tract infection, ventilator-associated pneumonia.

References

  1. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med 1999;27:887-92.
  2. Darouiche RO. Device-Associated Infections: A Macroproblem that Starts with Microadherence. Clin Infect Dis 2001;33(9):1567-1572.
  3. Gasink LB, Lautenbach E. Prevention and treatment of healthcare acquired infecti-ons. Med Clin North Am2008; 92:295-313.
  4. Hedrick TL, Sawyer RG. Health-care associated infections and prevention. Surg Clin North Am 2005;85:1137-52.
  5. Chandrakanth C, Anushree, Vinod A. Incidence of ventilator associated Pneumonia. Int J Med Clin Res 2010;1(2): 11-13.
  6. Safdar N, Fine JP, Maki DG. Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med 2005;142:451-466.
  7. Maki DG, Weise CE, Sarafin HW. A semi quantitative culture method foridentifying intravenous catheter-related infections N Engl J Med1977;296:1305-1309.
  8. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definitionof health care-associated infection and criteria for specific types of infectionsin the acute care setting. Am J Infect Control2008;36:309–332.
  9. Singh S, Pandya Y, Patel R, Paliwal M, Wilson A, Trivedi S. Surveillance of device associated infections at a teaching hospital in rural Gujarat – India. Indian J Med Microbiol 2010;28(4):342-7.
  10. Vonberg RP, Behnke M, Geffers C, Sohr D, Ruden H, Dettenkofer M, et al. Device associated infection rates for non-intensive care unit patients. Infect Control Hosp Epidemiol2006;27:357-61.
  11. Singhai M, Malik A, Shahid M, Malik MA, Goyal A Study on device-Related Infections with Special Reference to Biofilm Production and Antibiotic Resistance. J Glob Infect Dis  2012;4(4): 193–198.
  12. Manish N, Tankhiwale NS. Study of microbial flora in patients with indwelling catheter. Int J Cur Res Rev  2013;5(12):57-60.
  13. Dugal S, Purohit H. Antimicrobial susceptibility profile and detection of extended spectrum beta-lactamase production by gram negative uropathogens. Int J Pharm Pharmaceutic Sci 2013;5(4) 434-438.
  14. Payal MP, Tanuja JB, Sandeep N, Neelam PN. A study on ventilator associated pneumonia in pediatric age group in a tertiary care hospital, Vadodara. Natl J Med Res 2012; 2(3): 318-321.
  15. Tripathi S, Jain A, Kohli N. Study Of Ventilator Associated Pneumonia In Neonatal Intensive Care Unit: Charecter-isitcs, Risk Factors and Outcome. Internel J Med Update 2010;5(1):12-9.
  16. Gupta A, Agrawal A, Mehrotra S, Singh A, Malik S, Khanna A. Incidence, risk stratification, antibiogram of pathogens isolated and clinical outcome of ventilator associated pneumonia. Indian J Crit Care Med 2011; 15(27): 96-101.
  17. Ranjit S, Bhattarai B. Incidence and risk factors for ventilator-associated pneumonia in Kathmandu University Hospital. Kathmandu Univ Med J 2011;33 (1)28-31.
  18. Chawla R. Epidemiology, aetiology and diagnosis of hospital acquired pneumonia and ventilator associated pneumonia in Asian countries. Am J Infect Control 2008; 36 (4): 93- 100.
  19. Chopdekar K, Chande C, Chavan S, Veer P, Wabale V, Vishwakarma K, et al. Central venous catheter-related blood stream infection rate in critical care units in a tertiary care, teaching hospital in Mumbai. Indian J Med Microbiol 2011; 29: 169-171.
  20. Parameswaran R, Sherchan JB, Varma MD, Mukhopadhyay C, Vidyasagar S. Intravascular catheter-related infections in an Indian tertiary care hospital. J Infect Dev Ctries2011; 5(6):452-458.

Corresponding Author

Prof Dr K.V Suseela

Professor and HOD, Department of Microbiology Amala Institute of Medical Sciences Thrissur, Kerala, India, Mobile-8606398463