“STUDY OF INFECTIONS IN MEDICAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL”

Dr. Ratna R Prasad, Dr. Sharmila S Raut

Abstract


Patients admitted in Intensive Care Units are at great risk for acquiring nosocomial infections; also there is frequent use of
invasive devices. We conducted a study to isolate and identify the organisms causing infections in ICU and their
antimicrobial resistance pattern. Clinically diagnosed cases of infection after 48 hours of admission in the Medical ICU were included in study.
Depending on type of infections various samples were collected and processed as per standard guidelines. VAP was most common infection
followed by CAUTI and CLABSI. Their rate (per 1000 device days) being 32.04, 7.62 and 12.25. Among the 185 isolates, Gram negative
organisms predominated. A.baumannii was the most frequent isolate followed by K.pneumoniae, P.aeruginosa, S.aureus, E.coli, C.tropicalis,
C.albicans etc. Majority of organisms were highly resistant to common antibiotics used. Problem of multidrug-resistance can be prevented by
rational use of antibiotics after standardised antibiotic susceptibility testing.


Keywords


VAP, CAUTI, CLABSI

Full Text:

PDF

References


Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin C D, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K. International Study of the Prevalenceand Outcomes of Infection in Intensive Care Units. JAMA.2009;302(21):2323-232.

Mehta A, Rosenthal VD Mehta Y, Chakravarthy M, Todi SK, Sen N et.al. Device-associated nosocomial infection rates in intensive care units of seven Indian cities. Findings of the International Nosocomial Infection Control Consortium (INICC). Journal of Hospital Infection. 2007; 67: 168-74.

Shaikh JM, Devrajani DB, Ali Shah SZ, Akhund T, Bibi I.Frequency, pattern and etiology of nosocomial infection in intensive care unit: an experience at a tertiary care hospital. J Ayub Med Coll Abbottabad 2008;20(4):37-40

Malhotra S, Sharma S, Hans C. Prevalence of Hospital Acquired Infections in a tertiary care hospital in India. Int. J. Med. Sci. 2014;1(7):91–4.

Markogiannakis H, Pachylaki N, Samara E, Kalderi M, Minettou M, Toutouza M, et.al. Infections in a surgical intensive care unit of a university hospital in Greece. Int J of Inf Dis. 2009; 13:145—153

Horan TC, Andrus ML, Dudeck MA. CDC/NHSN surveillance definition of healthcare-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36:309-32.

Collee JG, Duguid JP, Fraser AG, Marmion BP, Simmons A. laboratory strategy in the diagnosis of infective syndromes. In: Collee JG, Marmion BP, Fraser AG, Simmons A, editors. Mackie and Mc Cartney`s Practical Medical Microbiology. 14th ed. New Delhi: Reed Elsevier India Private Limited; 1996. p 53-94.

Koneman EW, Allen SD, Janda MW, Schreckenberger PC, Winn WC. Introduction to Microbiology. Part II. In: Colour atlas in textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 1997g. pg 67-110.

Bauer AW, Kirby WMM, Sherris JC, Truck M. Antibiotic susceptibility testing by a standardized single disc method. American J Clin Pathol 1966; 45: 493-6.

Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement. Clinical Laboratory Standards Institute (CLSI) 2014.

Sahu MK, Siddharth B, Choudhury A, Vishnubhatla S, Singh SP, Menon R, et al. Incidence , microbiological profile of nosocomial infections , and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit. 2016;C(2):281–7.

Mythri H, Kashinath KR. Nosocomial Infections in Patients Admitted in Intensive Care Unit of a Tertiary Health Center, India. Ann Med Health Sci Res. 2014 SepOct; 4(5): 738–741.

Klompas M, Nosocomial Pneumonia. In: Mandell, Douglas, and Bennett`s, editors. Principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier Churchill Livinstone; 2015(vol 2):3325-33.

Singh S, Chaturvedi R, Garg SM, Datta R, Kumar A. Incidence of healthcare associated infection in the surgical ICU of a tertiary care hospital. Medical Journal Armed Forces India.2013; 69(2):124-9

Dasgupta S, Das S, Chawan NS, Hazra A. Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian J Crit Care Med 2015;19:14-20.

Datta P,Rani H. Chauhan R, Gombar S, Chander J. Health-care-associated infections: Risk factors and epidemiology from an intensive care unit in Northern India. Indian Journal of Anesthesia. 2014; 58(1): 30–35.

T Jaggi N, Sissodia P. Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiarycare hospital in India. J Clin Diagn Res. 2012;6:1372–6. [PMCID: PMC3471501] [PubMed: 23205350]

T Hooton TM, Nosocomial Urinary Tract Infection. In: Mandell, Douglas, and Bennett`s, editors. Principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier Churchill Livinstone; 2015(vol 2):3334-3346.

T Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections [Online]. 2009; Available from:http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/CAUTI_Guideline2009final.pdf.

T Singh S, Pandya Y, Patel R, Paliwal M, Wilson A, Trivedi S…. Surveillance of device­associated infections at a teaching hospital in rural Gujarat ­ India 2015;(4):1–7.

T Vasanthi R, Karthikeyan D, Jeya M. Study of biofilm production and antimicrobial resistance pattern of the bacterial isolates from invasive devices. Int J Res Health Sci [Internet]. 2014 Jan31;2(1):274-81. Available from http://www.ijrhs.com/issues.php?val=Volume2&iss=Issue1

T O’Grady NP, Barie PS, Bartlett J, et al. Practice parameters for evaluating new fever in critically ill adult patients. Task Force of the American College of Critical Care Medicine of the Society of Critical Care Medicine in collaboration with the Infectious Disease Society of America. Crit Care Med 1998; 26:392–408.

Vincent JL. Nosocomial infections in adult intensive-care units. Lancet 2003; 361:2068-77.

Pradhan NP, Bhat SM, Ghadage DP. Nosocomial Infections in the Medical ICU : A Retrospective Study Highlighting their Prevalence , Microbiological Profile and Impact on ICU Stay and Mortality. 2014;62:18–21.

Ghanshani R, Gupta R, Gupta BS, Kalra S, Khedar RS, Sood S. Epidemiological study of prevalence , determinants , and outcomes of infections in medical ICU at a tertiary care hospital in India. 2016;32(5):441–8.

Singh AK, Sen MR, Anupurba S, Bhattacharya P. Antibiotic sensitivity pattern of the bacteria isolated from nosocomial infections in ICU. J Commun Dis 2002; 34:257-63.

Shalini S, Kranthi K, Gopalkrishna BK. Microbiological profile of nosocomial infection in the intensive care unit. Journal of Clinical and Diagnostic Research 2010; 4:3109-12.

Patwardhan RB, Dhakephalkar PK, Niphadkar KB, Chopade BA. A study on nosocomial pathogens in ICU with special reference to multiresistant Acinetobacter baumannii harbouring multiple plasmids. 2008; (August):178–87.

Brusselaers N, Vogelaers D, Blot S. The rising problem of antimicrobial resistance in the intensive care unit. 2011;1–7.

Shalini S, Kranthi K, Gopalkrishna BK. Microbiological profile of nosocomial infection in the intensive care unit. Journal of Clinical and Diagnostic Research 2010; 4:3109-12.

Pattanayak C, Patanaik SK, Pratim P, Panda P. IJBCP International Journal of Basic & Clinical Pharmacology A study on antibiotic sensitivity pattern of bacterial isolates in the intensive care unit of a tertiary care hospital in Eastern India. 2013;2(2):153–9.

Ylipalosaari P, Ala-kokko TI, Laurila J, Ohtonen P, Syrjälä H. Intensive care acquired infection is an independent risk factor for hospital mortality : a prospective cohort study. 2006;10(2):1–6.


Refbacks

  • There are currently no refbacks.