Healthcare Associated Infections in Intensive Care Units: A Pilot Study in a Tertiary Care Public Hospital in India

Aim: HAIs occur worldwide, and infections acquired in health care settings are among the major causes of death and increased morbidity among patients. Economic costs of HAI are considerable. This study was conducted with the aim of evaluating the prevalence and effect of HAI on average length of stay of patients in ICU. Methods: This prospective matched cohort study was conducted in Respiratory ICU of PGIMER (a 2000 bedded tertiary care teaching hospital of North India), bed occupancy rate of 84%. All patients were categorised according to APACHE II scoring. Cases were defined per CDC criteria. VAP, CLABSI, CAUTI, SSI and CDI were the HAIs studied. Cases were matched with controls over 3 criteria. Patients were followed up till they were transferred out of RICU. Independent t-test, Chi square or Fisher's exact test was applied for comparison of 2 groups of normally distributed data. Mann-Whitney U-test was used as a test of significance for comparing matched cases and controls. Results: A cohort of 100 patients observed after informed consent. Mean age- 42.92 years. 29/100 developed 52 episodes of HAI. VAP was the commonest HAI, 62%, followed by CLABSI and CAUTI. Pseudomonas aeruginosa was isolated in 27.6% followed by Staphylococcus haemolyticus and E. coli. Results showed that patients admitted with higher APACHE II score developed HAI significantly more than patients admitted with a lower score. Significantly higher mortality was observed in patients with HAI. Patients who developed HAI stayed for an average of 14.9 days more than patients who did not develop HAI. The results showed that patients who developed a HAI stayed in the hospital for an average of 11.96 days more than matched controls. Conclusion: There is a significant impact on ALS of patients with HAI upon adjusting for severity of illness. Hence, implementing and monitoring HAI surveillance is a prime concern.

Author(s):

Prerna Babbar*, Manisha Biswal, Behera Digamber, Anil Gupta

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