Analysis of the incidence of nosocomial infections in the medical icu – predisposing factors and microbiological profile

Author: 
Sartaj Hussain., Kamal K. Sawlani., Suraj S. Yadav., Manish Bajpai., Sanjay Khattri

Background: Nosocomial infections are a serious problem in the Intensive Care Unit (ICU) setup. They not only increase health care cost and duration of hospital stay but also affect outcome of patients.

Methods: A prospective observational study conducted in Intensive Care Unit (ICU) of the Department of Medicine at a tertiary care teaching hospital. The patients stayed for more than 48 hours were included in the study. A total 74 patients were recruited. The CDC/ NHSN surveillance definition of health care associated infection were followed for nosocomial infections.

Results: The nosocomial infection developed in 43.24% of patients. The ventilator associated pneumonia (VAP) developed in 40.62% patients followed by urinary tract infection (UTI) (25%), VAP and UTI both (25%), VAP and bloodstream infection (BSI) (9.38%). The patients who developed nosocomial infection were having significantly higher age, APACHE II Score and length of stay in compare to those not developed. Most frequently isolated microorganisms were Klebsiella pneumoniae and Acinetobacter baumannii. The mortality rate was significantly higher in patients with nosocomial infections. The major determinant for the development of nosocomial infections were ventilation and length of stay.

Conclusions: The incidence of nosocomial infections is higher as compared to other studies. The hospital acquired infection control program and monitoring system, well trained staff with continued education may reduce the rates of nosocomial infection.

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