Device Associated Hospital Acquired Infections in a Tertiary Care Hospital in Western Odisha

Abstract

Introduction: Hospital Acquired Infection (HAI) is defined as infection that is acquired after 48 hours of admission in hospital for a reason other than that infection and the infection was neither present nor incubating at the time of admission. Device Associated Hospital Acquired Infections (DAHAIs) mainly Central Line Associated Blood Stream Infection (CLABSI), Ventilator Associated Pneumonia (VAP) and Catheter Associated Urinary Tract Infection (CAUTI) pose significant threat to patients associated with prolonged hospital stays, greater healthcare costs and increased mortality. Surveillance of Device Associated Infections (DAI) can reduce the incidence of Nosocomial Infections (NI) by as much as 32% and lead to reduced healthcare costs. Aim: To determine the microbiological profile of device associated HAI and to find the antimicrobial susceptibility pattern of the isolated organisms. Materials and Methods: This was a hospital based crosssectional study conducted in the Department of Microbiology, from November 2015 to October 2017. The study was targeted at three common DAHAIs: CAUTI, CLABSI and VAP. Patients admitted to clinical wards with 48 hours of indwelling devices like urinary catheter, central line and with endotracheal intubation developing signs and symptoms of DAI were included in the study. Specimen was collected with all aseptic precautions. Samples were processed by standard bacteriological methods. Isolates obtained were characterised by biochemical methods. Antibiotic susceptibility tests were done by Kirby Bauer discdiffusion method. Total of 425 samples were included in the study of which 152 (35.76%) showed positive growth and in 273 (64.24%) samples culture was sterile. The samples were collected from Intensive Care Unit (ICU) and various wards. The results were expressed in terms of mean, percentage and rate. Results: A CAUTI was the most common 53.28%, followed by VAP 37.51% and then CLABSI 9.21%. Escherichia coli was most commonly isolated organism 38 (23.45%) followed by Staphylococcus aureus 30 (18.51%). In CAUTI Escherichia coli (38.27%) was most commonly isolated and Acinetobacter baumannii (32.25%) was most commonly seen in VAP and in CLABSI Candida spp. (31.57%) was predominantly isolated. Conclusion: This study gave an insight into the incidence and prevalence of DAHAIs and helps in instituting various interventional strategies to prevent these infections.