Surveillance of Healthcare-Associated Bloodstream and Urinary Tract Infections in a National Level Network of Indian Hospitals (original) (raw)
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The Lancet Global Health
Background Health-care-associated infections (HAIs) cause significant morbidity and mortality globally, including in low-income and middle-income countries (LMICs). Networks of hospitals implementing standardised HAI surveillance can provide valuable data on HAI burden, and identify and monitor HAI prevention gaps. Hospitals in many LMICs use HAI case definitions developed for higher-resourced settings, which require human resources and laboratory and imaging tests that are often not available. Methods A network of 26 tertiary-level hospitals in India was created to implement HAI surveillance and prevention activities. Existing HAI case definitions were modified to facilitate standardised, resource-appropriate surveillance across hospitals. Hospitals identified health-care-associated bloodstream infections and urinary tract infections (UTIs) and reported clinical and microbiological data to the network for analysis. Findings 26 network hospitals reported 2622 health-care-associated bloodstream infections and 737 health-careassociated UTIs from 89 intensive care units (ICUs) between May 1, 2017, and Oct 31, 2018. Central line-associated bloodstream infection rates were highest in neonatal ICUs (>20 per 1000 central line days). Catheter-associated UTI rates were highest in paediatric medical ICUs (4•5 per 1000 urinary catheter days). Klebsiella spp (24•8%) were the most frequent organism in bloodstream infections and Candida spp (29•4%) in UTIs. Carbapenem resistance was common in Gram-negative infections, occurring in 72% of bloodstream infections and 76% of UTIs caused by Klebsiella spp, 77% of bloodstream infections and 76% of UTIs caused by Acinetobacter spp, and 64% of bloodstream infections and 72% of UTIs caused by Pseudomonas spp. Interpretation The first standardised HAI surveillance network in India has succeeded in implementing locally adapted and context-appropriate protocols consistently across hospitals and has been able to identify a large number of HAIs. Network data show high HAI and antimicrobial resistance rates in tertiary hospitals, showing the importance of implementing multimodal HAI prevention and antimicrobial resistance containment strategies.
Background: Healthcare associated infections (HAIs) are prevalent and difficult to treat worldwide. Most HAIs can be prevented by effective implementation of Infection Prevention and Control (IPC) measures. A survey was conducted to assess the existing IPC practices across a network of Indian Hospitals using the World Health Organization designed self-assessment IPC Assessment Framework (IPCAF) tool. Methods: This was a cross sectional observation study. Thirty-two tertiary care public and private facilities, part of the existing Indian HAI surveillance network was included. Data collected was analyzed by a central team at All India Institute of Medical Sciences, New Delhi, a tertiary care hospital of India. The WHO questionnaire tool was used to understand the capacity and efforts to implement IPC practices across the network. Results: The overall median score of IPCAF across the network was 620. Based on the final IPCAF score of the facilities; 13% hospitals had basic IPC practices, 28% hospitals had intermediate and 59% hospitals had advanced IPC practices. The component multimodal strategies had the broadest range of score while the component IPC guidelines had the narrowest one. Conclusions: Quality improvement training for IPC nurses and healthcare professionals are needed to be provided to health facilities.
The Indian journal of medical research, 2017
Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. A series of four cross-sectional point prevalence surveys were carried out between March and August 2014. Data of each patient admitted were collected using a structured data entry form. Centers for Disease Control and Prevention guidelines were used to identify and diagnose patients with HAI. Overall prevalence of HAI was 3.76 per cent. Surgical Intensive Care Unit (ICU) (25%), medical ICU (20%), burns ward (20%) and paediatric ward (12.17%) were identified to have significant association with HAI. Prolonged hospital stay [odds ratio (OR=2.81), mecha...
American journal of infection control, 2017
Surveillance of health care-associated infections (HAIs) plays a key role in the hospital infection control program and reduction of HAIs. In India, most of the surveillance of HAIs is reported from private sector hospitals that do not depict the situation of government sector hospitals. Other studies do not confirm with the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance criterion, or deal with ventilator-associated pneumonia (VAP) instead of ventilator-associated event (VAE). The aim of this study was to identify the incidences of 3 device-associated HAIs (DA-HAIs) (VAE, central line-associated bloodstream infection [CLABSI], and catheter-associated urinary tract infection [CAUTI]) by active surveillance using CDC's NHSN surveillance criteria and to identify the pathogens associated with these DA-HAIs. This was a prospective surveillance study (January 2015-December 2016) conducted in an intensive care unit (ICU) of...
Indian Journal of Medical Research, 2017
Background & objectives: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. Methods: A series of four cross-sectional point prevalence surveys were carried out between March and August 2014. Data of each patient admitted were collected using a structured data entry form. Centers for Disease Control and Prevention guidelines were used to identify and diagnose patients with HAI. Results: Overall prevalence of HAI was 3.76 per cent. Surgical Intensive Care Unit (ICU) (25%), medical ICU (20%), burns ward (20%) and paediatric ward (12.17%) were identified to have significant association with HAI. Prolonged hospital stay [odds ratio (OR=2.81), mechanical ventilation (OR=18.57), use of urinary catheter (OR=7.89) and exposure to central airconditioning (OR=8.59) had higher odds of acquiring HAI (P<0.05). Interpretation & conclusions: HAI prevalence showed a progressive reduction over successive rounds of survey. Conscious effort needs to be taken by all concerned to reduce the duration of hospital stay. Use of medical devices should be minimized and used judiciously. Healthcare infection control should be a priority of every healthcare provider. Such surveys should be done in different healthcare settings to plan a response to reducing HAI.
TAJ: Journal of Teachers Association
Introduction: Healthcare-associated infections represent significant obstacles to providing high-quality healthcare and have been directly linked to ineffective infection control procedures. There is currently a shortage of trustworthy data in Bangladesh describing the epidemiology of hospital-acquired infections (HAIs), which is necessary for the development of effective infection prevention and control measures. This study's goal was to assess the frequency, nature, and risk factors of HAIs in acute care hospitals in Northern Bangladesh. Methods: This was a pilot point prevalent survey conducted in the medicine, surgery, gynecology, and obstetrics departments of Rajshahi Medical College Hospital between August 2022 to September 2022. Data were collected by two questionnaires for disease profile and hospital-acquired infection. In addition, a checklist was used for the observation of the infection prevention and control (IPC) status of different wards. Result: Approximately 900...
Blood stream infections-prevalence in a tertiary care institute, Central India
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Septicaemia is responsible for high morbidity and mortality in developing countries like India requiring prompt antimicrobial treatment for its proper management. AIMS AND OBJECTIVES: Detection of etiological agent from blood culture of suspected septicaemia patients and it's antibiogram. Material and Methods: A total of 227 blood culture samples were collected in Microbiology Laboratory during 1 July-2016 to 30 June-2017. Etiologic agents were isolated using conventional as well as automated blood culture methods and their antibiotic susceptibility was determined using standard protocol. Results: Among clinically suspected septicemic patients 39(17.18%) were culture positive. The most common organisms isolated were S. aureus(12), CONS(8), Klebsiella pneumoniae(5) and C. albicans(4) in decreasing order of their incidence. 75% of S. aureus were methicillin resistant. All Gram positive organisms were sensitive to Glycopeptide antibiotics but showed variable resistance to other antibiotics. Gram negative bacteria were multidrug resistant with high degree of resistance towards Quinolones, Cephalosporins but a high sensitivity to Carbapenems. Only one non fermenter was resistant to Carbapenems which was sensitive to Colistin. Conclusion: The use of automation can be a useful tool for isolation of rare organisms. The incidence of bacterial culture positivity is on the rise and fungal isolation is also common. In this era where over the counter drugs are easily available, drug abuse is difficult to control. But, having said that, formulation of Hospital Antibiotic Policy and its strict implementation is the need of the hour, which will eventually help us to control the menacing rise in antimicrobial resistance.