Reshu Agarwal1, Sarita Mohapatra2, Girija Prasad Rath3, Arti Kapil4. 1. Senior resident, Department of Microbiology, AIIMS, New Delhi, India. 2. Assistant Professor, Department of Microbiology, AIIMS, New Delhi, India. 3. Professor, Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, India. 4. Professor, Department of Microbiology, AIIMS, New Delhi, India.
Abstract
INTRODUCTION: Health Care Associated Infections (HCAI) are frequent complications in neurosurgery. There is limited data available on the incidence and burden of HCAI in neurosurgical patients of Southeast Asian region. AIM: To identify various HCAIs, associated aetiological agents and their antimicrobial susceptibility pattern among the patients admitted in the neurosurgery unit. MATERIALS AND METHODS: An observational prospective study was carried out for three months duration on all neurosurgical patients admitted to a tertiary-care center. The site-specific nosocomial infection rates and device utilization ratios were calculated. Data on demographic profiles, invasive procedures, HCAI, isolated microorganisms and antimicrobial susceptibilities were recorded. Statistical analysis of all the variables was done. The association between categorical variables was assessed by Chi-square/Fisher-exact test. Continuous variables such as infected and non-infected were compared by Wilcoxon rank-sum test. A p-value of less than 0.05 was considered significant. RESULTS: A total of 330 patients with 4054 patient-days were analysed for HCAI. Twenty-two HCAIs were identified in 21 patients. The overall rate of HCAI was 6.67% and 5.42 per 1000 patient-days. Urinary Tract Infection (UTI) was most common (71.4%) followed by Laboratory Confirmed Blood-Stream Infection (LCBI) (28.5%) and pneumonia (4.7%). No central line-associated blood stream infection was identified. Klebsiella pneumoniae and Escherichia coli were the most common organisms causing UTI and LCBI. All the isolates (100%) were found to be multidrug resistant. CONCLUSION: This study generates a baseline data for records of device-associated infection in neurocritical care patients, which will further help monitoring its trend of infection and antimicrobial resistance pattern. Moreover, it will help in the formulation of the antibiotic policy and the preventive measures which may reduce morbidity and mortality.
INTRODUCTION: Health Care Associated Infections (HCAI) are frequent complications in neurosurgery. There is limited data available on the incidence and burden of HCAI in neurosurgical patients of Southeast Asian region. AIM: To identify various HCAIs, associated aetiological agents and their antimicrobial susceptibility pattern among the patients admitted in the neurosurgery unit. MATERIALS AND METHODS: An observational prospective study was carried out for three months duration on all neurosurgical patients admitted to a tertiary-care center. The site-specific nosocomial infection rates and device utilization ratios were calculated. Data on demographic profiles, invasive procedures, HCAI, isolated microorganisms and antimicrobial susceptibilities were recorded. Statistical analysis of all the variables was done. The association between categorical variables was assessed by Chi-square/Fisher-exact test. Continuous variables such as infected and non-infected were compared by Wilcoxon rank-sum test. A p-value of less than 0.05 was considered significant. RESULTS: A total of 330 patients with 4054 patient-days were analysed for HCAI. Twenty-two HCAIs were identified in 21 patients. The overall rate of HCAI was 6.67% and 5.42 per 1000 patient-days. Urinary Tract Infection (UTI) was most common (71.4%) followed by Laboratory Confirmed Blood-Stream Infection (LCBI) (28.5%) and pneumonia (4.7%). No central line-associated blood stream infection was identified. Klebsiella pneumoniae and Escherichia coli were the most common organisms causing UTI and LCBI. All the isolates (100%) were found to be multidrug resistant. CONCLUSION: This study generates a baseline data for records of device-associated infection in neurocritical care patients, which will further help monitoring its trend of infection and antimicrobial resistance pattern. Moreover, it will help in the formulation of the antibiotic policy and the preventive measures which may reduce morbidity and mortality.
Authors: Y Berrouane; I Daudenthun; B Riegel; M N Emery; G Martin; R Krivosic; B Grandbastien Journal: J Hosp Infect Date: 1998-12 Impact factor: 3.926
Authors: M Dettenkofer; W Ebner; F J Hans; D Forster; R Babikir; J Zentner; K Pelz; F D Daschner Journal: Acta Neurochir (Wien) Date: 1999 Impact factor: 2.216
Authors: Erich Schmutzhard; Klaus Engelhardt; Ronny Beer; Gregor Brössner; Bettina Pfausler; Heinz Spiss; Iris Unterberger; Andreas Kampfl Journal: Crit Care Med Date: 2002-11 Impact factor: 7.598
Authors: Małgorzata Kołpa; Marta Wałaszek; Anna Różańska; Zdzisław Wolak; Jadwiga Wójkowska-Mach Journal: Int J Environ Res Public Health Date: 2019-03-13 Impact factor: 3.390
Authors: Elżbieta Rafa; Małgorzata Kołpa; Marta Zofia Wałaszek; Adam Domański; Michał Jan Wałaszek; Anna Różańska; Jadwiga Wójkowska-Mach Journal: Int J Environ Res Public Health Date: 2022-06-20 Impact factor: 4.614