Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004–2013: Findings of the International Nosocomial Infection Control Consortium

Mehta, Yatin; Jaggi, Namita; Rosenthal, Víctor D.; Kavathekar, Maithili Satish; Sakle, Asmita Sagar; Munshi, Nita; Chakravarthy, Murali; Todi, Subhash; Saini, Narinder Kumar; Rodrigues, Camilla; Varma, Karthikeya K; Dubey, Rekha; Kazi, Mohammad Mukhit; Udwadia, Farokh; Myatra, Sheila Nainan; Shah, Sweta; Dwivedy, Arpita; Karlekar, Anil; Singh, Sanjeev; Sen, Nagamani; Limaye-Joshi, Kashmira; Ramachandran, Bala; Sahu, Suneeta; Pandya, Nirav; Mathur, Purva; Sahu, Samir; Singh, Suman; Bilolikar, Anil Kumar; Kumar, Siva; Mehta, Preeti; Padbidri, Vikram; Nadimpalli, Gita; Patnaik, Saroj Kumar; Francis, Thara; Warrier, Anup; Muralidharan, S; Nair, Pravin K; Subhedar, Vaibhavi; Gopinath, R.; Azim, Afzal; Sood, Sanjeev

doi:10.1017/ice.2015.276

Cited by 56 publications

(40 citation statements)

References 18 publications

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“…As the CDC's NSHN HAI surveillance guidelines was globally accepted to follow, their data can be considered as a benchmark to compare our HAI rates along with national and state HAI data available. Very fortunately, our CA-UTI incidence rate in 2018 was almost equally similar to the CDC and INICC data 13,14 . This was achievable only by constant individual case-based route-cause analysis and continuous education to the various levels of Health-care workers in our institute over the course of this study, especially to all the staff nurses and residents posted in all intensive and emergency care areas.…”

Section: Resultssupporting

confidence: 77%

“…Over the course of study period, in 2018 the incidence rate of CA-UTI was determined as 2.9 CA-UTI per 1000 Catheter days (Table 1). According to INICC India, data for HAI rates which was published in 2016 representing pooled data of 40 hospitals from 20 cities in India (10 years data) states that, the pooled CA-UTI rate was 2.13 per 1000 device days 13 . Month-wise distribution of CA-UTI incidence showed uniform peak during July and September, which could be due to the new batch of staffs and residents recruitment.…”

Section: Resultsmentioning

confidence: 99%

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Incidence, Bacteriological Profile and Antibiotic Resistance Pattern of Catheter Associated Urinary Tract Infections in a Tertiary Care Hospital

Raman¹,

Venugopal²,

Easow³

et al. 2019

J Pure Appl Microbiol

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During the past three decades, especially in developed countries there are adequate and effective Hospital Acquired Infection (HAI) control programs and implementations are being focused. But in developing countries, due to lack of awareness and effective implementable infection control policies, there is no adequate comparative data to validate the safe healthcare delivery system. Thus this descriptive surveillance study was aimed to find the Incidence rate of Catheter Associated Infections (CA-UTIs) in a tertiary care hospital, Puducherry over a period of three years (2016, 2017 & 2018). From all confirmed CA-UTI cases, demographic details, patient distribution, bacteriological profile and antibiotic resistance pattern was aimed. Strict hand hygiene, aseptic practices and catheter bundle care approaches were meticulously emphasized and monitored regularly. The incidence rate of CA-UTI during 2016, 2017 and 2018 was calculated as 7.9, 4.8 and 2.9 per 1000 catheter days respectively. Male gender preponderance was noticed, with majority of age-group belongs to 61 years and above. E.coli and Klebsiella pneumoniae were found to be the commonest bacterial Uro-pathogens with moderate to high level resistance to various antibiotics tested. This study ensures that strict hand hygiene, appropriate and adequate usage of Personal Protective Equipment's (PPE), aseptic measures and adherence to infection control bundles will reduce the incidence and burden of CA-UTI.

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Section: Resultssupporting

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Incidence, Bacteriological Profile and Antibiotic Resistance Pattern of Catheter Associated Urinary Tract Infections in a Tertiary Care Hospital

Raman¹,

Venugopal²,

Easow³

et al. 2019

J Pure Appl Microbiol

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“…In this study, we applied strict diagnostic criteria for CLABSI [18]. CLABSI was diagnosed only in neonates from whom the catheter was removed at the time of or soon after the onset of the episode of BSI, and in whom culture of the catheter tip was positive for the same organism that was cultured from the blood.…”

Section: Discussionmentioning

confidence: 99%

“…The indicated treatment for CoNS BSI included intravenous antibacterial therapy for at least 5 days after the date of the blood culture (or until death) [1, 4]. We defined all concurrent infectious foci, including NEC, ventilator associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and meningitis according to the U.S. Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) definitions [8, 18–20]. Only cases with NEC ≥ stage IIA in modified Bell’s criteria (definite NEC) were enrolled, and clinically defined VAP cases were considered [8].…”

Section: Methodsmentioning

confidence: 99%

Incidence, clinical features, and implications on outcomes of neonatal late-onset sepsis with concurrent infectious focus

Tsai

Lai

et al. 2017

BMC Infect Dis

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BackgroundNeonatal bloodstream infection (BSI) is the most important cause of morbidity and mortality in the neonatal intensive care unit (NICU). Although most neonatal BSIs are primary bacteremia, some are associated with a focus of infection. This distinction is not well characterized.MethodsAll patients with neonatal late-onset sepsis (LOS) between January 2006 and December 2013 were enrolled. LOS was categorized as a BSI with a concurrent focus of infection if LOS occurred before or within 24 h after the diagnosis of a specific infectious entity, and as “primary bacteremia” if no concurrent focus of infection was identified. Data concerning demographics, hospital course, microbiology, and outcomes were compared via univariate and multivariate analyses.ResultsOf 948 episodes of neonatal LOS, 781 (82.4%) were primary bacteremia, whereas 167 (17.6%) were associated with a known focus of infection, including meningitis (n = 51, 5.4%), ventilator-associated pneumonia (VAP) (n = 36, 3.8%), catheter-related bloodstream infections (n = 57, 6.0%), and necrotizing enterocolitis (NEC) (n = 21, 2.2%). The majority of NEC-associated BSIs were caused by gram-negative bacilli (85.7%). Group B streptococcus accounted for nearly one-third of all meningitis cases (29.4%). Although sepsis-attributable mortality was comparable between primary bacteremia and neonatal BSIs with a focus of infection, neonatal BSIs with meningitis, VAP, and NEC had significantly higher rates of infectious complications. The independent risk factors of sepsis-attributable mortality were infectious complications (Odds ratio [OR] 6.98; 95% confidence interval [CI] 3.64–13.39, P < 0.001); history of one or more than one previous episode(s) of BSI (OR 2.40 and 7.40; 95% CI 1.21–4.74 and 3.70–14.78, P = 0.012 and <0.001, respectively); and underlying secondary pulmonary hypertension in neonates (OR 4.77; 95% CI 1.91–11.96, P = 0.001).ConclusionsA considerable proportion of neonatal LOS can be associated with known infectious foci in the NICU. The microbiologic etiology of neonatal LOS with a concurrent focus of infection is significantly different from that of primary bacteremia. Neonatal BSIs with concurrent meningitis, VAP, or NEC are significantly more likely to have infectious complications. This association independently leads to sepsis-attributable mortality.

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“…Our interventions resulted to a significant decrease in CLABSI rates from 15.9/1000DD (2015), to 4.2/1000DD (2016) and then to 1.95/1000DD during the 2017 surveillance period (phase three). The absolute 2017 rate appears to be lower than the majority of the reported published literature [5,8,36,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]. By the beginning of the next period (2016), our efforts resulted to a significant decrease in CLABSI rates from 15.9/1000DD (2015), to 4.2/1000DD (2016) and then to 1.95/1000DD during the 2017 surveillance period (phase three).…”

Section: Discussionmentioning

confidence: 79%

The effectiveness of a Comprehensive Device Associated Healthcare-Associated Infections Prevention and Control Program: results of a 3-year program in the Republic of Cyprus

Iordanou¹,

Middleton²,

Papathanassoglou³

et al. 2019

Preprint

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Background: Device-associated health care-associated infections (DA-HAIs) are a major threat to patient safety, particularly in the Intensive Care Unit (ICU). The aim of this study was to evaluate the effectiveness of a bundle of infection control measures to reduce DA-HAIs in the ICU of a General Hospital in the Republic of Cyprus, over a three-year period. Methods: We studied 599 ICU patients with length of stay (LOS) for at least 48 hours. Our prospective cohort study was divided into three surveillance phases. VAP, CLABSI, and CAUTI incidence rates, LOS and mortality were calculated before, during and after the infection prevention and control program. Results: There was a statistically significant reduction in the number of DA-HAI events during the surveillance periods, associated with DA-HAIs prevention efforts. In 2015 (prior to program implementation), the baseline DA-HAIs instances were 43: 16 VAP (10.1/1000 Device Days), 21 (15.9/1000DD) CLABSIs and 6 (2.66/1000DD) CAUTIs, (n=198). During the second phase (2016), CLABSIs prevention measures were implemented and the number of infections were 24: 14 VAP (12.21/1000DD), 4 (4.2/1000DD) CLABSIs & 6 (3.22/1000DD) CAUTIs, (n=184). During the third phase (2017), VAP and CAUTI prevention measure were again implemented and the rates were 6: (3 VAP: 12.21/1000DD), 2 (1.95/1000DD) CLABSIs & 1 (0.41/1000DD) CAUTIs, (n=217). There was an overall reduction of 87% in the total number of DA-HAIs instances for the period 01/01/15 to 31/12/17. Conclusions: The significant overall reduction in DA-HAI rates, indicates that a comprehensive infection control program can affect DA-HAI rates.

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Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004–2013: Findings of the International Nosocomial Infection Control Consortium

Abstract: Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.

Cited by 56 publications

References 18 publications

Incidence, Bacteriological Profile and Antibiotic Resistance Pattern of Catheter Associated Urinary Tract Infections in a Tertiary Care Hospital

Incidence, Bacteriological Profile and Antibiotic Resistance Pattern of Catheter Associated Urinary Tract Infections in a Tertiary Care Hospital

Incidence, clinical features, and implications on outcomes of neonatal late-onset sepsis with concurrent infectious focus

The effectiveness of a Comprehensive Device Associated Healthcare-Associated Infections Prevention and Control Program: results of a 3-year program in the Republic of Cyprus

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