Epidemiology and Risk Factors of Healthcare Associated Infections in Critically Ill Patients in a Tertiary Care Teaching Hospital in Nepal

2018 ◽  
Vol 46 (6) ◽  
pp. S2
Author(s):  
Sailesh Kumar Shrestha ◽  
Pradeep Krishna Shrestha
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Healthcare Associated

scholarly journals An 8-year point-prevalence surveillance of healthcare-associated infections and antimicrobial use in a tertiary care teaching hospital in China

2018 ◽  
Vol 147 ◽  
Author(s):  
Yi-Le Wu ◽  
Xi-Yao Yang ◽  
Meng-Shu Pan ◽  
Ruo-Jie Li ◽  
Xiao-Qian Hu ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Long Term Trends ◽  
Healthcare Associated

AbstractHealthcare-associated infections (HAIs) are a major worldwide public-health problem, but less data are available on the long-term trends of HAIs and antimicrobial use in Eastern China. This study describes the prevalence and long-term trends of HAIs and antimicrobial use in a tertiary care teaching hospital in Hefei, Anhui, China from 2010 to 2017 based on annual point-prevalence surveys. A total of 12 505 inpatients were included; 600 HAIs were recorded in 533 patients, with an overall prevalence of 4.26% and a frequency of 4.80%. No evidence was found for an increasing or decreasing trend in prevalence of HAI over 8 years (trend χ2 = 2.15, P = 0.143). However, significant differences in prevalence of HAI were evident between the surveys (χ2 = 21.14, P < 0.001). The intensive care unit had the highest frequency of HAIs (24.36%) and respiratory tract infections accounted for 62.50% of all cases; Escherichia coli was the most common pathogen (16.67%). A 44.13% prevalence of antimicrobial use with a gradually decreasing trend over time was recorded. More attention should be paid to potential high-risk clinical departments and HAI types with further enhancement of rational antimicrobial use.

scholarly journals A study of birth defects in a tertiary care teaching hospital at Chennai, India

2017 ◽  
Vol 6 (7) ◽  
pp. 3067
Author(s):  
Mangalageetha Amirthalingam ◽  
Padmalatha Dakshnamurthy ◽  
Vinodhini Shanmugham
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Teaching Hospital ◽  
Congenital Anomalies ◽  
Maternal Age ◽  
Tertiary Care ◽  
Maternal Diabetes ◽  
Advanced Maternal Age ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: The Congenital anomalies were estimated to be the fifth largest cause of neonatal deaths in India. The purpose of our study was to determine the proportion and pattern of congenital anomalies and their association with risk factors like maternal diabetes, advanced maternal age and consanguinity among the babies born in a tertiary care teaching hospital in Chennai.Methods: This study is a cross sectional descriptive study where all the newborns including still born delivered with the presence of congenital anomalies and those fetuses terminated due to detection of presence of congenital anomalies were analyzed. The study was done at the OBG department in a tertiary care center for a period of one year 1st June 2015 to 31st May 2016.Results: The overall incidence of birth defects were 2.36%, of which musculo skeletal defects (18.88%) were commonly found. There was a definite correlation of risk factors with consanguinity showing an incidence of 1.5 times the overall incidence of birth defects (3.54%) and maternal diabetes mellitus was 6 times the total incidence (15.3%). The correlation between the incidence of birth defects and advanced maternal age was not statistically significant in our study.Conclusions: The study depicts the risk of occurrence of congenital anomalies in the presence of maternal diabetes and in consanguineous marriage and emphasizes on the necessity of adequate screening like first trimester and second trimester ultrasonogram for the early detection of anomalies in the fetus especially if these risk factors are present in the mother.

Study of incidence of acute renal failure and its associated factors and complications amongst patients admitted in intensive care unit of a tertiary care teaching hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 108-111
Author(s):  
Rameshwar A Warkad ◽  
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital

Background: Impairment of renal function is a serious complication in critically ill patients. Mortality of acute renal failure remains high ranging from 35% to 86% despite haemodialysis therapy and substantial improvement of dialysis techniques. Therefore attention must be paid to the conditions favouring deterioration of renal function in order to prevent acute renal failure or to intervene in an early phase when less invasive therapies might be even more promising. Methods: This prospective study was conducted in a tertiary care teaching hospital in Mumbai from 1st January 2006 to 31st December 2006. All patients consecutively admitted in intensive care unit were studied. Results: Total number of patients admitted during the said period to the Intensive care Unit was 406, of which 50 had evidence of acute renal failure. The incidence of acute renal failure in the critically ill patients included in our study was 12.31%. There was a statistically significant difference in the incidence of fluid overload, oliguria and hyperkalemia between the pre-renal and renal failure groups. Conclusion: The incidence of acute renal failure in the critically ill patients was 12.31% and commonest predisposing factors associated with acute renal failure were acute insults like hypotension, sepsis and risk factors like age >50 years and pre-existing renal disease.

scholarly journals A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 1336 ◽  
Author(s):  
G. Ganitha ◽  
G. Anuradha
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Teaching Hospital ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Maternal Morbidity And Mortality ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

scholarly journals 2472. Point Prevalence of Healthcare-Associated Infections and Antibiotic Use in a Tertiary Care Teaching Hospital in Nepal: A Cross-Sectional Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S856-S856
Author(s):  
Sailesh Kumar. Shrestha ◽  
Swarup Shrestha
Keyword(s):  
Teaching Hospital ◽  
Prevention And Control ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Cross Sectional ◽  
Care Teaching ◽  
Resource Limited ◽  
Number Of Patients ◽  
Healthcare Associated ◽  
And Control

Abstract Background Healthcare-associated infections (HAIs) are a growing threat to patient safety, particularly in resource-limited settings. Information on the burden of HAIs will help in surveillance and prevention efforts. This study aims to estimate the prevalence of HAIs and antibiotics use in a tertiary care teaching hospital in Nepal. Methods We conducted a descriptive cross-sectional point prevalence survey in a 350 bedded acute care teaching hospital at Kathmandu, Nepal on April 2019 in a single day for every ward. We studied all the patients aged ≥ 18 years admitted for at least two calendar days on the day of the survey to collect data on patient characteristics, hospital stay, and invasive devices and antibiotics used. We evaluated for the three common HAIs – pneumonia, urinary tract infection and surgical site infection, active on the day of data collection using the clinical criteria by European Center for Disease Prevention and Control protocol version 5.3. We summarized continuous variables with median and interquartile range (IQR) and categorical variables with proportions. We reported the prevalence of HAIs as a proportion of the number of HAIs by the number of patients studied. Results Of 213 inpatients, 160 were eligible, 25 (15.6%) among them were from critical care units. The median age was 50 years (IQR 34–65). The median duration of hospital stay was 6 days (IQR 4–9). There were 18 HAIs for the prevalence of 11.25%. Urinary tract infection was the most common HAI (13 HAIs, 72.2% of all HAIs). We found invasive devices used in 42 patients (26.2%), the most common was urinary catheter (37 patients, 23.1%). The number of patients with any antibiotic used was 114 (71.25%) with 61 (38%) patients receiving two or more antibiotics. Third-generation Cephalosporins were the most common antibiotics (74, 64.9%) used. We found 91 (79.8%) patients being treated for community-acquired infections. Conclusion This study provides an estimate of the burden of HAIs in our center that is comparable to that of the reports from other resource-limited settings. However, we believe a higher burden will be revealed when we add microbiological criteria as well to diagnose HAIs. This highlights an urgent need for HAI surveillance system, infection prevention and control, and antibiotics stewardship programs in our center. Disclosures All authors: No reported disclosures.

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