One-fourth patients admitted to GMCH-32 ICUs acquire additional infections: Study

CHANDIGARH: One fourth of those admitted in the ICUs of Government Medical College and Hospital (GMCH), Sector 32, acquire additional infections during their stay there. And 13% of these get infected due to ventilators. An observational study was conducted in the multi-disciplinary ICUs by the department of microbiology. The study was conducted on 250 patients admitted in the ICU from January 2017 to June 2018.

Healthcare associated infections (HAI) are those acquired after 48 hours of admission for any healthcare setting up to 30 days of discharge and up to one year in case of implants surgery, which was not evident at the time of admission. "The incidence of HAI was found to be 24%. The study shows a moderate prevalence of infections in patients hospitalized in the ICU," said Prof Jagdish Chandra, head of the microbiology department, GMCH-32.

The multidisciplinary ICU of the GMCH had cases post-operative of neurosurgery, orthopaedic surgery, cases of cardiac conditions, chronic kidney diseases and diabetes. Long duration of ICU stay, age more than 60 years and co-morbid conditions like suffering with diabetes and immuno-compromised immunity is significantly associated with HAI. It is estimated that 5-10% of the patients admitted to acute care hospitals anywhere in the country develop HAIs. The common type HAIs are catheter associated urinary infection, central line associated blood stream infection, ventilator associated pneumonia and surgical site infection. HAIs account for major cause of death, functional disability, emotional suffering and economic burden among hospitalized patients.

The study found that the ventilator-associated pneumonia (VAP) was diagnosed as one of the most common HAI (found in 33 patients) with incidence of 13.2% . Of the 60 patients with HAI, 33 were diagnosed with VAP. The second commonest HAI was by catheter associated urinary infection with incidence of 8.4% and the incidence of central line associated blood stream infection was 2.4%. The most common organism isolated in the study that causes HAI was acinetobacter cbc (25 isolates), escherichia coli (12 isolates) kiebseilla pneumoniae (11 isolates), pseudomonas aeruginosa ( 9 isolates) and enterococcus species (3 isolates).

The study recommended stringent infection control and proper implementation of protocols in the hospital.

As many as 21 patients out of 250 had catheter associated urinary infection (CAUTI) . The most common organism isolated in CAUTI was escherichia coli. Acinetobacter cbc is the leading cause of respiratory infections leading to influenza. Escherichia coli infections are mainly due to contaminated food. Kiebseilla pneumoniae can cause severe pneumonia or blood infection. Multi-drug resistance was seen in a large percentage of acinetobacter species, kiebseilla pneumoniae and pseudomonas aeruginosa.