Study of pattern and etiological factors of nosocomial infections in critical care unit in a multispecialty, tertiary care hospital in Central India

Abstract

Background: Nosocomial infection is a key factor determining the clinical outcome, especially among patients admitted in critical care areas. The objective of the study was to ascertain the pattern and risk factors of nosocomial infections in Critical Care Unit in a tertiary care hospital.Methods: This prospective, observational clinical study included patients admitted in intensive care unit over a period of one and a half years. Routine surveillance of various nosocomial infections such as catheter‑associated urinary tract infections, central‑line‑associated blood stream infections, and ventilator‑associated pneumonias was done through specific infection surveillance proforma.Results: Out of 679 patients, 166 suffered 198 episodes of device‑associated infections. The infections included CAUTI, CLABSI, and VAP. The number of urinary tract infection episodes was found to be 73 (10.75%) among the ICU patients who had indwelling urinary catheter. In addition, for 1 year CAUTI was calculated as 9.08/1000 catheter days. The number of episodes of blood stream infection was 86 (13.50%) among ICU patients having central line catheters. Also, CLABSI was found to be 13.86/1000 central line days. A total of 39 episodes (6.15%) of VAP was found in ICU patients over 18 months and VAP present for 6.04/1000 ventilator days.Conclusions: The organisms most commonly associated with nosocomial infections were Pseudomonas Aeruginosa and Acinetobacter species. The risk factors identified as being significantly associated with device associated infections in our ICU were diabetes, COPD and ICU stay for ≥8 days (p<0.05).