Device-associated nosocomial infection in the intensive care units of a tertiary care hospital in northern India

Rani, Hena; Chauhan, Rajni; Gombar, Satinder; Chander, Jagdish

doi:10.1016/j.jhin.2010.06.013

Cited by 11 publications

(3 citation statements)

References 6 publications

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“…Information on pathogens causing all ICU-associated infections was available from 11 studies [13,16,28,32,36,43,47,50,52,58,61], six studies included microbiological data specifically related to VAP [13,14,26,28,58,59], seven had data related to CAUTI [13,14,28,37,56,58,59] and six had CLABSI data [13,14,21,28,58,59].…”

Section: Etiology Of Infection Acquired In Icumentioning

confidence: 99%

Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review

Saharman

Karuniawati

Severin

et al. 2021

Antimicrob Resist Infect Control

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Background Intensive care units (ICUs) in lower-middle income countries (LMICs) are suspected to constitute a special risk for patients of acquiring infection due to multiple antibiotic resistant organisms. The aim of this systematic scoping review was to present the data published on ICU-acquired infections and on antimicrobial resistance observed in ICUs in LMICs over a 13-year period. A systematic scoping review was conducted according to the PRISMA extension guideline for scoping reviews and registered in the Open Science Framework. Main body of the abstract Articles were sought that reported on ICU-acquired infection in LMICs between 2005 and 2018. Two reviewers parallelly reviewed 1961 titles and abstracts retrieved from five data banks, found 274 eligible and finally included 51. Most LMICs had not produced reports in Q1 or Q2 journals in this period, constituting a large gap in knowledge. However, from the reported evidence it is clear that the rate of ICU-acquired infections was comparable, albeit approximately 10% higher, in LMICs compared to high income countries. In contrast, ICU mortality was much higher in LMICs (33.6%) than in high income countries (< 20%). Multidrug-resistant Gram-negative species, especially Acinetobacter baumannii and Pseudomonas aeruginosa, and Klebsiella pneumoniae played a much more dominant role in LMIC ICUs than in those in high income countries. However, interventions to improve this situation have been shown to be feasible and effective, even cost-effective. Conclusions Compared to high income countries the burden of ICU-acquired infection is higher in LMICs, as is the level of antimicrobial resistance; the pathogen distribution is also different. However, there is evidence that interventions are feasible and may be quite effective in these settings. Protocol Registration The protocol was registered with Open Science Framework (https://osf.io/c8vjk)

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Section: Etiology Of Infection Acquired In Icumentioning

confidence: 99%

Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review

Saharman

Karuniawati

Severin

et al. 2021

Antimicrob Resist Infect Control

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“…According to the International Nosocomial Infection Control Consortium (INICC), the rates of CLABSI are significantly higher in ICUs in low-income countries (6.8 per 1000 central line-days) than the US (2.0 per 1000 central line-days) [ 39 ]. Additionally, the microbiologic spectrum varies, with a higher tendency for gram-negative bacteria to cause CLABSI in developing countries [ 40 – 43 ] as opposed to gram-positive bacteria in developed countries [ 27 ]. Poor infrastructure, inadequate hygienic maneuvering of vascular catheters, and a lack of knowledge regarding CVC safety may contribute to the increased risk of CLABSI in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: a safety and feasibility study

Islam

Rahman³

et al. 2017

Pilot Feasibility Stud

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BackgroundIn Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood. The aim of this study is to define the clinical feasibility and safety of SVPE in patients with GBS in resource poor settings.MethodsA total of 20 adult patients with GBS will be enrolled for SVPE at a single center in Bangladesh. Six daily sessions of whole blood sedimentation and plasma removal will be performed in all patients with GBS with a target to remove an overall volume of at least 8 liters (L) of plasma over a total of 8 days. Serious adverse events (SAE) are defined as the number of patients developing severe sepsis associated with the central venous catheter or deep venous thrombosis in the limb where the catheter is placed for SVPE. Based upon a predictive success rate of 75%, the SVPE procedure will be considered safe if less than 5 of 20 SVPE-treated GBS patients have a SAE. The procedure will be considered feasible if 8 L of plasma can be removed in at least 15 of 20 patients with GBS who receive SVPE. In addition, detailed clinical and neurological outcome assessments will be performed until discharge of the patient from the hospital and up to 4 weeks after study entry.DiscussionThis is the first clinical study to evaluate the feasibility and safety of SVPE as a potential alternative low-cost treatment for the patients with GBS in resource poor settings.Trial registrationClinicaltrials.gov NCT02780570 Electronic supplementary materialThe online version of this article (10.1186/s40814-017-0185-0) contains supplementary material, which is available to authorized users.

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“…Various factors account for these high incidences, among which is the use of invasive medical devices such as central line catheters (CVC), indwelling urinary catheters (IUC), and mechanical ventilators (MV), as well as poor adherence by staff to evidence-based infection prevention recommended care procedures (7, 8). The use of invasive devices has become the primary method of care for ICU patients, but their use breaches the body’s normal defense mechanisms a risk factor for acquiring an HAI (9).…”

Section: Introductionmentioning

confidence: 99%

A Survey of Adherence to Guidelines to Prevent Healthcare-Associated Infections in Iranian Intensive Care Units

Shamshiri¹,

Suh²,

Mohammadi³

et al. 2016

Iran Red Crescent Med J

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BackgroundHealthcare-associated infections (HAIs) are acquired by patients while receiving care. The highest incidence of HAIs has been documented in admissions to intensive care units. Adherence to evidence-based practices is the most important step for preventing HAIs.ObjectivesTo determine the rate of adherence to evidence-based post-insertion recommended care practices after admission into the intensive care unit for the following devices: central line catheter, indwelling urinary catheter, and mechanical ventilator.Patients and MethodsA structured observational cross-sectional research design was used. Data were collected using a checklist and a self-report questionnaire. The minimum sample size required for this study was 276 post-insertion care episodes, and 332 episodes were observed. The ANOVA test was used to identify any significant differences among the mean scores of the three devices.ResultsOverall observed adherence rates were 18.3%, 59.1%, and 43.1% for central line catheters, indwelling urinary catheter, and mechanical ventilator, respectively. Of the observed episodes of device care, only in 9.4% of the episodes was regular oral care performed for patients on mechanical ventilators and only in 19.3% of the episodes were indwelling urinary catheters properly secure after insertion. More so, in none (0.0%) of the episodes was the central line catheter hub disinfected before being accessed.ConclusionsEvidence-based post-insertion recommended care practices were not consistently and uniformly implemented in the intensive care units. Establishment of a program for the surveillance of adherence to recommended guidelines is required for improving compliance by health professionals and the quality of preventive care.

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Device-associated nosocomial infection in the intensive care units of a tertiary care hospital in northern India

Cited by 11 publications

References 6 publications

Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review

Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: a safety and feasibility study

A Survey of Adherence to Guidelines to Prevent Healthcare-Associated Infections in Iranian Intensive Care Units

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