Abstract
BackgroundPatients admitted to the Intensive Care Unit (ICU) are prone to develop nosocomial infections due to Multidrug-Resistant (MDR) organisms. Inappropriate and overuse of antibiotics play an important role in the emergence of MDR organisms, which cause life-threatening infections resulting in significant morbidity and mortality.MethodsRetrospective surveillance-based study on healthcare-associated infections. The study conducted over two consecutive years 2018 and 2019, looking at ICU related infections of a regional secondary care general hospital and the data were recorded using the methods and definitions of the Kuwait National Healthcare-associated infections Surveillance System (KNHSS).ResultsA total of 1408 patients, admitted to ICU for 7922 days during the 2 years period. Eighty-nine patients were included in this study, where 48 developed one Hospital-acquired Infections (HAI) in the ICU while 25 and two patients presented with two and three HAIs, respectively. The HAIs included Bloodstream Infections (BSI) — 42.3%, pneumonia — 28.8%, Urinary Tract Infections (UTI) — 15.3%, skin and soft tissue infections — 9.6% and Clostridium difficile infection — 3.4%. The overall infection rate was 13.14 per 1000 patient-days. The rates for Device-associated (DA)-HAIs were 6.27 for Central Line-associated BSI (CLABSI) per 1000 Central Line (CL)-days, 4.21 for Ventilator-associated Pneumonia (VAP) per 1000 Mechanical Ventilator (MV)-days, and 1.91 Catheter-associated UTI (CAUTI) per 1000 Urinary Catheter (UC)-days. Data showed that device use ratios for CL, MV, and UC were 0.81, 0.74, and 0.98, respectively. Acinetobacter baumannii and Klebsiella pneumoniae were the most common organisms isolated from the ICU infections with highest rates of antibiotic resistance.ConclusionAmong DA-HAIs CLABSI was found to be most common in our ICU, followed by VAP and CAUTI. Gram-negative organisms with A. baumannii and K. pneumoniae being the leading causative agents with high antimicrobial resistance profiles.
Highlights
Patients requiring life-saving support are invariably admitted to the Intensive Care Unit (ICU) of a health facility
9.6% of infection rate was found in a medical ICU [26] and a rate of 4.6% was observed in a high volume cardiac surgical ICU in India [27]
In a WHO systematic review and meta-analysis, it was shown that Hospital-acquired Infections (HAI) density in adult ICUs in developing countries was 47.9 per 1000 patient-days, which was found to be at least three times higher than densities reported from the USA [28]
Summary
Patients requiring life-saving support are invariably admitted to the Intensive Care Unit (ICU) of a health facility. They often undergo invasive procedures such as intra-tracheal intubation for mechanical ventilation, insertion of intravascular and urinary catheters, using monitoring devices as part of a routine or to closely monitor and deliver therapies resulting in Device-associated Hospital-acquired Infections (DA-HAIs) in some of the patients, especially if proper care-bundle is not observed [1,2]. There are usually several other risk factors in these patients making them vulnerable to develop nosocomial infections leading to high morbidity and mortality [3,4]. Patients admitted to the Intensive Care Unit (ICU) are prone to develop nosocomial infections due to MultidrugResistant (MDR) organisms. Inappropriate and overuse of antibiotics play an important role in the emergence of MDR organisms, which cause life-threatening infections resulting in significant morbidity and mortality
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
