Abstract
Background: Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs). Objectives: The study aims to elucidate their trends in an adult ICU. Methods: Over 21 months, monthly VAP, CLABSI, and CAUTI rate, and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. All cases of VAP, CLABSI, and CAUTI during these 21 months were included. In addition, monthly hand hygiene compliance rates were assessed during the latter period of the study by direct observation method. Results: Nosocomial DAI rate was 49.38 DAI/1000 ICU days. CAUTI, CLABSI, and VAP rates were 17.38, 26.85, 21.08 per 1000 device days, and device utilization ratios were 0.99, 0.61, and 0.02, respectively. Conclusion: The institute had high DAI rates in comparison to other studies from the same city. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. Thus, it establishes baseline data and underscores the need for focused HIC to maximize patient outcomes.
Highlights
Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs)
It subsequently amounted to 5446 patient days, followed up daily for DAIs as a component of HIC surveillance
HAI rates have been known to vary from 5%-10% in the developed nations, but substantially higher DAI rates surmounting 40% are reported from the developing world.[7,8,9,10]
Summary
Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs). Methods: Over 21 months, monthly VAP, CLABSI, and CAUTI rate, and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. It establishes baseline data and underscores the need for focused HIC to maximize patient outcomes. The increasing popularity of established and newer medical devices in health care has emanated the menace of device-associated infections (DAI), especially in intensive care units (ICUs). 95% of cases of urinary tract infections in critically ill patients are catheter-related, 87% of cases of bloodstream infections tend to bud from an indwelling vascular catheter, and mechanical ventilation contributes to 86 percent of cases of pneumonia.[2]
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