Abstract
BackgroundNosocomial infections are a global health problem, affecting 1.4 million people in treatment centers, responsible for 80,000 estimated annual deaths. The current study aimed to assess the factor influencing nosocomial infections and to choose the best antibiotic for its treatment through culture analysis.MethodologyThe current study was conducted in a tertiary care hospital Rawalpindi. A total of 120 patients with at least one nosocomial episode were included. Blood, urine, and wound swab sample were collected for hematology, biochemistry, electrolyte, and microbial analysis. Multivariate regression analysis through SPSS (ver. 16.0) were done, p-value of ≤ 0.05 was considered statistically significant.ResultThe prevalence of culture-confirmed nosocomial infection was 25%, among which age groups (P = 0.00, 95% CI, − .382-.271) were significantly correlated. Hematological analysis shows that 73.3% have lymphopenia (P = 0.00, 95% CI .567-1.175), 73.3% have Neutrocytosis (P = 0.00, 95% CI .553-1.122) and anemia (26.7%) (P = 0.002, 95% CI .097-.404) were statistically significant. Raised level of ALT (60%), Bilirubin (26.7%) and ALP (13.3%) among liver functional tests (P = 0.68, 95% CI .686- .280) found insignificant however abnormal level of urea (33.3%) and creatinine (46.7%) (P = 0.00, 95% CI -1.227-.392) were significantly correlated with nosocomial infections. Electrolytes profile shows that Hypernatremia (26.7%) (P = 0.000, 95% CI-.491–.227) were strongly correlated. Culture analysis isolated six bacterial agents, comprising 83.3%:16.6% ratio of gram-negative and gram-positive isolates. Klebsiella pneumonia was frequently isolated gram-negative, while Methicillin-Resistant Staphylococcus aureus was the only gram-positive isolate collected. Urinary tract infection (UTI) (36.6%) was frequently found, followed by bloodstream infection (26.6%) (BSI). The majority of the gram-negative isolates were sensitive to Imipenem while resistant to Amoxicillin + Clavulanic acid, Trimethoprim/sulfamethoxazole, cefoxitin, Levofloxacin, Norfloxacin, and linezolid antibiotics. Methicillin-resistant staphylococcus aureus was found sensitive against Trimethoprim/sulfamethoxazole while resistant towards linezolid, Imipenem, and Cefotaxime.ConclusionThe current study revealed that nosocomial infection is still prevalent in our hospital environment and the leading cause of drug resistance and dysfunctions of various factors like WBCs, LFTs, RFTs, electrolytes, coagulation factors and anemia, which can lead to morbidity and mortality.
Is Methicillin-Resistant Staphylococcus aureus More Virulent than Methicillin-Susceptible S. aureus? A Comparative Cohort Study of British Patients with Nosocomial Infection and Bacteremia
