Surveillance of device-associated hospital-acquired infections(DA-HAI)in ICUs plays a vitalrole in hospitalinfection control&quality assurance and in understanding the changing trend and implementation ofthe antibiotic stewardship program.There islimited data on DA-HAIreported from Indian ICUs. The single-center study aimed to assess the burden, microbiologic prole, and the trend of DA-HAIs over ve years based on active monthly surveillance data as a part of Infection control practices in a tertiary care hospital in South India. DA-HAI rates of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) per 1,000 device-days were calculated by dividing the total number of DA-HAIs by the total number ofspecic device-days and multiplying the result by 1,000. Overall DA-HAI rate of 1.46 per 1000 device days of whichCLABSI andVAP andCAUTI constituted 2.19, 2.09, and 0.42 per 1000 device days,respectively. Diabetes was the most common comorbidity associated with DA-HAI. In contrast to data from West gram negative organisms constituted the majority of etiological agentsin DA-HAIsregardless of the duration in ourstudy (82.45%), while gram positive organisms and fungi constituted only 17.54% & 0.87%, respectively. Notably, 96.15% of Acinetobacter baumannii isolates in VAP were carbapenem resistant (CR), while 54.54% Klebsiella pneumoniae wereCR. InCLABSI 75% of Enterococcusisolates were vancomycin resistant (VRE). InCAUTI 20% of gram negative organisms were CRandallEnterococcusfaeciumisolatesinwereVRE.TherewasincreasingtrendofCRgramnegativeorganisms causingDA-HAI.
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives Invasive fungal infections (IFI) are one of the major causes of morbidity and mortality in post-hematopoietic stem cell transplant (HSCT) recipients. Data from India are limited. The objective was to analyze the incidence, risk factors, and outcomes associated with IFI in our center. Methods Adult patients, who underwent marrow/stem cell transplantation between 2014-2018, in an oncology center in India, were included in this retrospective observational study. The revised consensus definition of IFI by the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) in 2008, was considered to define cases. Incidence, risk factors, and outcomes associated with IFI were analyzed. Results Out of the 126 patients who underwent HSCT between 2014-2018, 56 (44.4%) had Allo HSCT, 64 (50.8%) had auto HSCT and 6 (4.8%) had haplo-identical HSCT. A total of 83 (63%) were males and 43 (34%) females, 113 (83.9%) Asians, and 13 (10.3%) Africans. Total 111 (88%) patients received myeloablative conditioning and 24 (19%) received total body irradiation. The hematological conditions were acute myeloid leukemia (AML) n = 23 (18.25%), acute lymphoblastic leukemia (ALL) n = 16 (12.69%), chronic myeloid leukemia (CML) n = 4 (3.17%), Hodgkins lymphoma (HL) n = 17 (13.4%), non-Hodgkins lymphoma (NHL) n = 11 (8.73%), Myeloma n = 35 (27.7%), sickle cell disease n = 13 (10.31%), etc. Most patients received fluconazole 78 (61.9%) followed by micafungin 23 (18.25%), posaconazole 20 (15.87%), voriconazole 4 (3.17%), and liposomal amphoterin B 1 (0.79%) as antifungal prophylaxis. The overall rate of IFI (possible cases included) was auto-HSCT n = 5 (7.81%), and Allo-HSCT n = 5 (8.92%). Among auto-HSCT, the IFI was Proven = 0, Probable n = 1 (1.5%), and Possible n = 4 (6.25%), and among Allo-HSCT Proven = 0, Probable n = 2 (3.57%), and Possible n = 3 (5.35%). These cases had IFI lung based on imaging and serological tests. None of the cases had a lung biopsy. There were no incidents of candidemia. No patients in Haplo-HSCT had IFI. The 1-year survival rate among the IFI cases was 8/10 (80%). As the number of patients with IFI was very low, a meaningful comparison of the risk factors, and the impact of prophylactic regimens were difficult. Conclusions: The overall rate of IFI in HSCT patients in our setting was low compared to global data.
Background Sub-Saharan African countries overwhelmingly bear the burden of global HIV infection and measles outbreaks in children. Despite the significant impact of this double burden in Nigeria, the effect of HIV infection on measles antibody levels among children is unknown. This study was therefore conducted to compare the measles antibody levels among HIV infected and uninfected children. Methods The study was a descriptive comparative cross-sectional study among 180 HIV infected and uninfected children aged 2-10 year, recruited between August and December 2015 in a Tertiary Healthcare centre in Nigeria. Socio-demographic, clinical and anthropometric parameters were obtained. Blood samples were collected for haematologic evaluation (CD4+ cell count, full blood count) and serologic assay of measles antibody using IMMUNOLAB ELISA kit. Data was analyzed using SPSS version 20. Results A total of 90 HIV infected subjects and 90 age and sex-matched HIV-negative controls were analyzed. There were 48 males and 42 females aged between 2 to 10 years with a Male: Female ratio of 1.1:1 in both groups. The mean age was 5.4 years. While the seroprevalence of measles antibody was 46.7% among the HIV negative children, only 9% of the HIV infected subjects had positive antibody level. The antibody titre was also significantly lower among HIV infected subjects compared with controls with median measles antibody values of 3.3U/ml and 9.4U/ml respectively (p <0.001). HIV infected subjects with more than one dose of measles vaccine had significantly higher seroprevalence of measles antibody than those with single dose (38.5% vs 5.2%, p <0.003). Conclusion There was a low seroprevalence of measles antibody among vaccinated HIV infected children in Nigeria, with higher seroprevalence of measles antibody among children with more than one (1) dose of measles vaccine. It is therefore advocated that HIV infected children should be given additional dose(s) of measles vaccination.
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