Device-Associated Healthcare-Associated Infections (DA-HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit

Abstract

Mean rates of VAP, CLABSI, and CAUTI were 14.4, 8.1, and 4.5 per 1000 device days, which are comparable with Indian and global ICUs. Patients and HCPs form important reservoirs of infection. Resolute conviction and sustained momentum in Infection Control Initiatives are an essential step toward patient safety.

Typhoidal Salmonella and Emerging Resistance in Outbreak Proportions

“…Ongoing hospital-based surveillance programs for MDR infections should include Salmonella, which can be traced with epidemiological surveillance. [35][36][37][38] Capacity-building for regional laboratory services and outbreak preparedness are mandated for enhancing contingency and resilience capital of community-based health systems. [39][40][41] Typhoidal Salmonella has high epidemic potential amid the emergence of MDR and NARST, and thus forms an important threat in human congregations such as the Kumbh Mela in India, Hajj pilgrimage in Saudi Arabia, and displaced migrant camps.…”

Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

“…[15][16][17][18] The average length of secondary care admission was 3.6 days. [19][20][21] Healthcare for pilgrims from all countries is completely sponsored by Saudi Arabia through 141 Hajj medical centers and 100 ambulances; however, there are limitations in bed availability, ambulance transfers, and the daily follow-up of transferred patients. 5,11,22 Trend analysis from 2012 to 2016 revealed a modest decrease in patient attendance, largely attributable to the increase in self-care for chronic comorbidities.…”

“…2 Nevertheless, clinical suspicion increases the burden of laboratory testing, and institutionalization furthers healthcare-associated transmission. 21,31,32 With the Middle East catering to 10 million annual pilgrims and otherwise being a global transport hub, travel-related infections and public health emergencies need to be assessed, detected, and answered with robust health systems under a One-Health approach in consonance with international health regulations. 3,5,13,33,34 Quarantine, syndromic surveillance, and cluster investigation for endemic infectious diseases including dengue and Rift Valley fever can be feasible primary tools for mass gatherings during Hajj.…”

“…31,32 Health system interventions such as evidence-based surveillance systems including real-time and post-event surveillance, disaster decision support-systems, crossplatform wireless records systems, political patronage, legislative drug dispensing by local pharmacies, and capability assurance towards mass gathering medicine and travel medicine can facilitate the operational fecundity of various stakeholders. 13,14,21,29 The magnitude of the Hajj medical operations calls for a permanent Indian civil hospital sited near the Indian Hajj pilgrim office, directed by a medical specialist to oversee planning, operations, and coordination throughout the Hajj paradigm and be suspended in the lean period. The permanent incumbent for Hajj medical operations should be a specialist doctor with experience in healthcare administration.…”

Emerging Antimicrobial Resistance and Evolving Healthcare: Dangerous Crossroads for the Community and the Military

“…Surveillance of air, water, food, surfaces, medical devices, disinfectants, and staff along with linen disinfection and hospital waste disposal is ensured (53,54). Carriers are identified, quarantined, and pathogens are eradicated from hospital environment.…”