Prevalence and risk factors for drug resistance in patients with lower respiratory infections in Healthcare Associated Infection: a single centre study from Eastern India

Abstract

Background: Healthcare Associated Infections (HCAI) are associated with longer hospitalisations and increased morbidity and mortality. Lower respiratory infections including Pneumonia is an entity among healthcare associated infections mostly witnessed in nursing home residents, patients on long term care and patients receiving home or hospital based intravenous therapy and undergoing dialysis. Aim of the study to assess the prevalence and risk factors of resistance among the patients developing lower respiratory infections as a consequence of Healthcare Associated Infection.Methods: The study was conducted as a prospective cohort model. All the eligible patients were subjected to detailed history taking, clinical examination, laboratory and radiological investigations. All the categorical parameters were compared using Fisher’s exact test. Continuous parameters were compared using independent t-test. All the statistical analysis was carried out using the software Stata 15.1.Results: Majority of the patients were older than 60 yrs (73%). Death was significantly seen in persons under 60 years and associated pulmonary consolidation equal to or more than three zones (p<0.05). Klebsiella spp (20.95%), and Acinetobacter (6.1%) were most commonly isolated. Multi-drug and extensive drug resistance were encountered among these organisms. Male gender, immune-compromised patients, bilateral pulmonary involvement and hospitalisation for at least 48 hours in preceding 90 days were associated with isolation of MDR organism.Conclusions: Lower respiratory infection is an important component of healthcare associated infections. It needs targeted antibiotic therapy covering MDR organisms prevalent in the local population. Data from different institutions to corroborate findings regarding antibiotic resistance pattern of the microbes is recommended.