The Incidence of Device Associated Infections, Causative Microorganisms And Antibiotic Sensitivity Pattern in Icu

Abstract

Hospital acquired infections are infections that are neither present nor incubating when a patient enters hospital 1 . Despite progress in public health and hospital care, infections continue to develop in hospitalized patients, and may also affect hospital staff. 2 About nine per cent of inpatients have a hospital acquired infection at point of time. (3) Their effects vary from discomfort, functional disability and emotional stress to prolonged or permanent disability . Small proportion of patient deaths each year are primarily attributable to hospital acquired infections (2,3) . The economic costs are considerable. The increased length of stay for infected patients is the greatest contributor to cost. 2 The development of a surveillance process to monitor this rate is an essential first step to identify local problems and priorities, and evaluate the effectiveness of infection control activity. Surveillance, by itself, is an effective process to decrease the frequency of hospital-acquired infections. 2,5 This study was undertaken as a part of surveillance system for MICU to find out incidence of device associated infection rate, causative microorganisms and their antibiotic sensitivity pattern. In this study the attack rate of catheter associated Urinary Tract Infection was 52.63% and incidence of 83.33% per 1000 catheter days. Most common organisms isolated were Klebsiella (63.63%,) E-Coli (31.81% ) and Pseudomonas (4.54%). Eighty one percent of Klebsiella isolates, 76.47% of E. Coli isolates and 87.5% of Pseudomonas isolates were resistant for antibiotics tested. Out of total isolates tested, 58.82% were resistant to Gentamycin, 100% isolates were resistant to Ampicillin and Cefotaxim, 80% were resistant to Ciprofloxacin, 87.5% were resistant to Sulphamethaxazole and 42.10% were resistant to Furantoin. The proportion of days spent in the ICU in which the patient's treatment included invasive devices is increasing, in fact 25-50% of nosocomial infections are due to combined effect of the patient's own flora and invasive devices . Catheter-associated urinary tract infection (UTI), Central line-associated bloodstream infection (BSI), Ventilator-associated pneumonia (VAP) are among leading causes of mortality and morbidity among ICU patients.