Analysis of a multi-centric pooled healthcare associated infection data from India: New insights

Abstract

Aim: The aim of this study was to analyze the multi-center data of healthcare associated infections (HAIs) to assess the infection control (IC) scenario in India in context with Center for Disease Control (CDC)/National Healthcare Safety Network (NHSN) and International Nosocomial Infection Control Consortium (INICC) database. Materials and Methods: Four National Accreditation Board for Hospitals accredited hospitals contributed their raw data on HAIs-number of days and number of infections in all intensive care patients were obtained as per the CDC-NHSN definitions and formulae. Three major device related infections were considered for analysis based on the prevalence of HAIs and discussions with subject experts. All nodal champions from each hospital were trained and common data collection sheet for surveillance in accordance to CDC-NHSN was formed. The pooled means for HAI rates and average of the pooled means for all were calculated using data from them and compared with CDC/NHSN and INICC percentiles. Results: The Indian pooled mean HAI rates for all infections were above CDC/NHSN percentile threshold but below INICC percentile. Ventilator associated pneumonia was considered as a matter of prime concern, crossing P90 line of CDC/NHSN threshold. However, no HAI rate was in the limit of P25. Conclusion: Indian HAI rates were higher when mapped with CDC threshold. This suggests the requirement for more standardized and evidence based protocols to tackle the HAIs with an aim to achieve the benchmark within CDC/NHSN thresholds. However, the 4 hospitals have better HAI rates as compared to pooled INICC database.