Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;24(4):159-165.
doi: 10.1177/17571774231161821. Epub 2023 Mar 10.

Health care associated infections, antimicrobial resistance and outcomes in patients admitted to intensive care unit, India: A five-Year retrospective cohort study

Santenna Chenchula  1 , Balakrishnan Sadasivam  1 , Ajay Shukla  1 , Saman Pathan  1 , Saurabh Saigal  2
Affiliations

Health care associated infections, antimicrobial resistance and outcomes in patients admitted to intensive care unit, India: A five-Year retrospective cohort study

Santenna Chenchula et al. J Infect Prev. 2023 Jul.

Abstract

Background: The present study was conducted to study the prevalence of HAIs in a newly established MICU, common microorganisms causing HAIs and their antibiotic-sensitivity profile, and antimicrobial utilization and mortality rate.

Methods: The present retrospective cohort study was carried out at AIIMS, Bhopal (2015-2019). The prevalence of HAIs was determined; sites of HAIs and common causative microorganisms were identified, and their antibiotic-sensitivity profiles were studied. The group of patients with HAIs was matched with a control group drawn from the pool of patients without HAIs; this matching was done with respect to age, gender, and clinical diagnosis. Antimicrobial utilization, Period of ICU stay, comorbidities and patient mortality rates in the two groups were analyzed. The clinical criteria by the CDC- National Nosocomial Infections Surveillance to diagnose HAIs.

Results: A total of 281 ICU patients' records were analyzed. The mean age was 47.21 ± 19.07 years. Of these 89 were found to have developed ICU-acquired HAIs (Prevalance:32%). Bloodstream infections (33%) and respiratory tract infections (30.68%), catheter-associated urinary tract infections (25.56%), and surgical site infections (6.76%) were the commonest. The most frequently isolated microorganism causing HAIs was K. pneumonia (18%), A. baumannii (14%) and E. coli (12%), 31% isolates of which were multidrug resistant. The average length of ICU stay was high in patients with HAIs (13.85 vs 8.2 days). The most common co-morbidity was type 2 diabetes mellitus (42.86%). Prolonged ICU stays [OR 1.13, (95% CI; 0.04-0.10)] and the presence of HAIs [OR 1.18(95%CI; (0.03-0.15)] were associated with an increased risk of mortality.

Conclusions: An increased prevalence of HAIs essentially bloodstream infections and respiratory infections with MDR organisms to antimicrobials in the watch group is highly considerable. Acquisition of HAIs with MDR organisms and increased length of hospital stay are considerable risk factors for increased mortality in ICU-admitted patients. Regular antimicrobial stewardship activities and revising existing hospital infection control policies accordingly may reduce HAIs.

Keywords: Intensive care unit; Nosocomial infections; antimicrobial resistance; hospital aquired infection; respiratory tract infections.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The Percentage of HAIs identified in study Subjects.
Figure 2.
Figure 2.
The most common organism isolated in HAIs.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Benenson AS. (1995) Control of Communicable Diseases Manual. 16th edition. Washington, DC, USA: American Public Health Association.
    1. Chawla R. (2008) Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia in Asian countries. American Journal of Infections and Control 36: 93–100. - PubMed
    1. Chaudhury A, Rani AS, Kalawat U, et al. (2016) Antibiotic resistance & pathogen profile in ventilator-associated pneumonia in a tertiary care hospital in India. Indian Journal of Medical Research 440–6: 440. - PMC - PubMed
    1. Choudhuri AH, Chakravarty M, Uppal R. (2017) Epidemiology and characteristics of nosocomial infections in critically ill patients in a tertiary care intensive care unit of Northern India. Saudi J Anaesth 11: 402–407. - PMC - PubMed
    1. Chenchula S, Gupta R, Sadasivam B, et al. (2018) In vivo resistance to ceftriaxone in enteric fever": In a tertiary care teaching hospital, Central India. International Journal of Innovative Research in Medical Science 3: 124–125.

LinkOut - more resources