A Study on Device Associated Infections in the Adult Intensive Care Unit at a Tertiary Care Hospital

Title: A STUDY ON DEVICE ASSOCIATED INFECTIONS IN THE ADULT INTENSIVE CARE UNIT AT A TERTIARY CARE HOSPITAL Introduction: The surveillance of Device associated infections in ICUs can reduce incidence of Nosocomial infections (NIs), healthcare cost& a better control of infections. Aims& Objectives: 1. To know the occurrence of device associated infection rate in ICU.2. To know the bacterial profile of various devices associated infections. Materials and Methods: This study was conducted between October 2011 to May 2012 in a six bedded adult ICU. A total of 1000 specimens of endotracheal aspirate; catheterized specimen urine and intravenous blood were collected from 567 eligible patients (CDC criteria). Identification of pathogens, antibiotic susceptibility testing was carried out as per standard guidelines. Extended Spectrum -Lactamase (ESBL), Inducible AmpC -Lactamase, Plasmid-mediated AmpC production, and Metallo-Lactamase (MBL) were tested for Gram negative bacilli by Combined disc diffusion method, Disk antagonism, Modified three-dimensional test, and Modified Hodge Test (MHT) respectively. Methicillin resistant Staphylococcus aureus (MRSA)& inducible clindamycin resistant (D-test) were tested for Gram positive bacteria. The data were analysed for determining DAI rate for Ventilator Associated Pneumonia (VAP), Catheter Associated Urinary Tract Infections (CA-UTI)& Central Line Associated Blood Stream Infections (CLA-BSI) using CDC guidelines. Results: DAI rates for VAP, CLA-BSI and CAUTI were 38.7, 7.6 and 1.47 /1000 device days respectively. Acinetobacter baumannii and Pseudomonas aeruginosa were predominant isolates. MBL (85 %)& ESBL (62 %) were most common resistance mechanisms for Acinetobacter baumannii and Pseudomonas aeruginosa respectively. Conclusion: VAP was most common infection. Multidrug resistant (MDR) A. baumannii& Ps. aeruginosa were predominant organisms. Most common resistance mechanisms were MBL for A. baumannii& ESBLs for Ps. aeruginosa.