Prospective surveillance of device-associated health care–associated infection in an intensive care unit of a tertiary care hospital in New Delhi, India

Kumar, Shilpee; Sen, Purnendu; Gaind, Rajni; Verma, Priyanka; Gupta, Poonam; Suri, Prem Rose; Nagpal, Sunita; Kumar, Anil

doi:10.1016/j.ajic.2017.08.037

Cited by 36 publications

(33 citation statements)

References 18 publications

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“…As a paradox of the epidemiological transition, the incidence and prevalence of healthcare‐associated infections (HAIs) have increased in parallel with the development of healthcare technology over the past century and, to date, HAIs are a major public health concern in high‐, middle‐ and low‐income countries. Respiratory tract infections (RTIs) are among the most common and life‐threatening HAIs and affect primarily critical patients admitted to intensive care units (ICUs). The crude mortality rate associated with ventilator‐associated pneumonia, the most frequent respiratory tract infection in the ICU, ranges from 0% to 60%, and the attributable mortality rate is estimated to be ≥13.0%.…”

Section: Introductionmentioning

confidence: 99%

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial

Bellíssimo-Rodrigues

Menegueti

Gaspar

et al. 2018

International Dental Journal

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Section: Introductionmentioning

confidence: 99%

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial

Bellíssimo-Rodrigues

Menegueti

Gaspar

et al. 2018

International Dental Journal

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“…In the present study, the incidence of infection was 2.03%, which is similar to study by Dettenkofer et al 9 but less as compared with Orsi et al 10 The study by Kumar et al showed that prevalence rate of infection in neurosurgical patients was high (18%) when it was not a dedicated NSICU. 11 In our study, CAUTI are most prevalent followed by BSIs, whereas in other studies, the most common infection was respiratory tract, followed by infections of the urinary tract. 9,10,12 We observed only a single case of ventilator-associated pneumonia (VAP) as compared with other studies.…”

Section: Discussionmentioning

confidence: 41%

Infections in Neurosurgical Intensive Care Patients: A 3-Year Study in a Tertiary Health Care Center, North India

Chaturvedi

Jena

Tarai

et al. 2019

Journal of Neuroanaesthesiology and Critical Care

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Background In the neurosurgical patient community, infection rate depends on the severity of neurological injuries at the time of presentation, which is measured by the Glasgow coma score (GCS). In addition, associated comorbidities; exposure to invasive devices such as endotracheal tube, central venous catheters, and urinary catheters; and neuroscience-specific devices, such as ventricular/lumbar catheters, increase chances of infection. We share our experience from a dedicated neurosurgical intensive care unit (NSICU) of a super speciality tertiary care hospital in north India. Patients and Methods This is a 3-year retrospective and observational study from January 2014 to December 2016. Total 2,608 patients were admitted to NSICU during this period; 229 patients were included whose cultures were collected after 48 hours of admission and were positive. We have analyzed patient's risk factors, length of stay (LOS), outcome, organism details, and those health care–associated infections (HAI) that fulfilled the CDC (Centers for Disease Control and Prevention) criteria. Results Out of 2,608 patients admitted, 229 were culture positive after 48 hours of admission and 53 developed HAIs (53/2,608 [2.03%]). Male-to-female ratio was 2:1. One hundred three patients had a low GCS (5–8) and 126 had a high GCS (9–15). Average LOS in ICU was 6 days, and mortality was 17.4% (40/229). A total of 57 laboratory-confirmed positive cultures were identified in 53 patients. This included 35 from urine, 15 from blood, 2 from surgical wound, and 1 from respiratory tract. Among the HAI, the rate of ventilator-associated pneumonia (VAP) was 0.22, central line-associated bloodstream infection (CLABSI) 3.43, catheter-associated urinary tract infection (CAUTI) 5.93, and surgical site infection (SSI) 0.9%. Conclusion Neurosurgical patients are particularly vulnerable to infection because of the formidable nature of their illness, frequency of associated trauma, and presence of invasive devices. In our study, lower rate of HAIs was observed because we have a dedicated NSICU, strict infection control practices, an appropriate antimicrobial stewardship program, and early shifting of neurosurgical patients to an appropriately staffed high-dependency unit/ward.

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“…The third more frequently encountered type of DA-HAI for all surveillance periods was CAUTI; however, those rates and instances were lower compared to the several previous reports [37,39,49,50,[52][53][54][55][56][57][58]66,41,[69][70][71][72][73][74][75][42][43][44][45][46][47][48]. A noticeable reduction was also found in the rates and instances per 1000DD, in the third phase (2017).…”

Section: Discussionmentioning

confidence: 78%

“…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%

“…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). The absolute 2017 rate appears to be lower than the majority of the reported published literature [5,8,[48][49][50][51][52][53][54][55][56][57]36,[58][59][60][41][42][43][44][45][46][47]. By comparing DA-HAI rates between 2015 and 2016 (phases one and two), a strong correlation was found, but there was no significant correlation between the 2016 vs. 2017 period.…”

Section: Discussionmentioning

confidence: 86%

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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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Prospective surveillance of device-associated health care–associated infection in an intensive care unit of a tertiary care hospital in New Delhi, India

Cited by 36 publications

References 18 publications

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial

Infections in Neurosurgical Intensive Care Patients: A 3-Year Study in a Tertiary Health Care Center, North India

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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