Five Years Trend of Device Associated Hospital-Acquired Infections in a Tertiary Care Hospital in South India-a Prospective Surveillance Study.

Abstract

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 prole, 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 ofspecic 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.