scholarly journals 772. Effect of Selective Digestive Decontamination Using Oral Colistin on HAI Rates and All-Cause Mortality Among Cardiovascular Surgery Patients - A Single Centre Experience from India

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S483-S483
Author(s):  
Sneha R ◽  
Arun Wilson ◽  
Anup R Warrier ◽  
Shilpa Prakash ◽  
Reima Elizabeth ◽  
...  
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Selective Digestive Decontamination ◽  
Care Hospital ◽  
Intervention Period ◽  
All Cause Mortality ◽  
Study Participants ◽  
Hospital Acquired ◽  
Interventional Group

Abstract Background Hospital acquired infections affect the morbidity and mortality of ICU patients considerably. Selective digestive decontamination (SDD) is defined as the prophylactic application of topical, non-absorbable antimicrobials in the oropharynx and stomach, with the goal of eradicating potentially pathogenic microorganisms but preserving the protective anaerobic microbiota. SDD has been applied in trials among critically ill patients and found to be effective in reducing HAI. Methods This cohort study was conducted in our cardiothoracic vascular surgery ICU of a tertiary care hospital, where patients were given oral colistin syrup (100mg 6th hourly for 5 days) in the immediate post op during the intervention period. We compared the clinical and microbiological outcomes of patients before (5 months, pre-intervention arm) and after (5 months, intervention arm) the implementation of SDD (Oral colistin syrup). Results A total of 78 patients were included in the interventional arm with a mean age of 58.7 years whereas the pre-interventional group consisted of 94 study participants with a median age of 57.5 years. 11 out of 94 had positive respiratory sample culture (11.7%) in the preintervention group which mandated antibiotic therapy for HAP compared to one culture positive in the interventional period (OR 0.0980, 95% CI: 0.0124 to 0.777 and P=0.0279). One patient had blood stream infection in the pre-intervention period compared to none in the intervention phase. All-cause mortality in the pre-interventional group was 7.44% (7 in 94) vs 1.28% (1 in 78) in the interventional group (OR 0.1614, 95% CI: 0.0194 to 1.3416, P= 0.0914). Adverse events (nausea, vomiting & loose stools) were observed in a total of 24 study patients, but necessitated withdrawal of regimen only in nine patients. Conclusion An SDD regimen of Colistin alone in Cardiac Surgery patients resulted in statistically significant reduction in incidence of Hospital Acquired Pneumonia, along with a reduction in all-cause mortality (though not statistically significant). Disclosures All Authors: No reported disclosures

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals MICROORGANISMS VARIANTS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN A SELECTED TERTIARY CARE HOSPITAL

2021 ◽  
pp. 22-25
Author(s):  
SARALA KS ◽  
NANDAKUMAR BS ◽  
NARENDRANATH V
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Secondary Data ◽  
Blood Stream ◽  
Microbial Flora ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Set Up ◽  
Healthcare Associated

Objective: Microorganisms are minute and can be only in microscope and these are not visible to naked eyes. Various types of microbe include bacteria, virus, fungi, and protozoa. These microorganisms are subclassified and these are disease causing leading to mortality and morbidity. Healthcare-associated infections (HAIs) arise from different variants of microbes and knowing the category of microbes for treating the diseases with specific antibiotics is important for better patient outcome. Methods: Using secondary data, all the patients who had HAI for 3 years were taken into consideration by considering the different variants of microorganisms. Results: Retrospective data collected for the period of 3 years the inpatients who got admitted for more than 48 h of duration, the data collected included the parameters for various microorganisms such as Bacilli, cocci, Klebsiella, Acinetobacter, and Aures, other micro-organisms such as Escherichia coli, Citrobacter, and Pseudomonas microorganisms. Bacilli group of microorganisms was more common for urinary tract infection, blood stream infection, and ventilator-associated pneumonia. Aures was more common among surgical site infection infections. Conclusions: Most of the patients who had an HAI had two or more different kind of microorganisms which are responsible for spreading infection. There is a need to control microbial flora in the hospital set up as the rate of HAI increases with microbial flora.

Epidemiology of nosocomial infections in medicine intensive care unit at a tertiary care hospital in northern India

2008 ◽  
Vol 38 (4) ◽  
pp. 233-235 ◽  
Author(s):  
Shabina Habibi ◽  
Naveet Wig ◽  
Sunil Agarwal ◽  
Surendra K Sharma ◽  
Rakesh Lodha ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infections ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Care Hospital ◽  
Northern India ◽  
Third Generation Cephalosporins

This prospective observational study describes the rates of nosocomial infections (NI), the sites of infection, the pathogens involved, their antibiogram and the risk factors at a tertiary care hospital in northern India. In 62 of the 182 enrolled patients 95 episodes of NI were recorded (incidence rate 28.6/1000 person days): pneumonia (77%); urinary tract infection (24%) and blood stream infection (24%). All isolates of Acinetobacter, Pseudomonas and Klebsiella and 83.3% of Escherichia coli were resistant to the third generation cephalosporins. An increased duration of the time spent in intensive care units and days of intervention were associated with incident NI.

Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

2021 ◽  
Vol 28 (03) ◽  
pp. 338-343
Author(s):  
Shah Ali Ahmed ◽  
Anwarul Haque ◽  
Qalab Abbas ◽  
Humaira Jurair ◽  
Zohra Qamar ud Din ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Central Line ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

scholarly journals 183. Candidaemia in Children and Importance of Central Venous Catheter Removal

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S112-S113
Author(s):  
Kamile Arikan ◽  
Sevtap Arıkan-Akdaglı ◽  
Ates Kara
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Attributable Mortality ◽  
Care Hospital ◽  
Central Venous ◽  
Candida Spp

Abstract Background Candida is the most common cause of invasive fungal infection in healthcare settings and is associated with significant increases in healthcare resource utilization and attributable mortality. Methods This study was conducted in a pediatric tertiary care hospital from Turkey. We conducted a retrospective analysis in children ≤18 years with blood culture-proven candidaemia identified between December 2013 and November 2017. Sociodemographic variables,underlying condition, mortality, additional risk factors, origin of specimens were all recorded. Results A total of 236 episodes of candidaemia were identified over the study period. The median age of the patients was 600 days (4-6482). 106 specimens (44.9%) were cultured from patients under 1 year of age and 15 of 106 specimens were cultured from neonates. The most frequently isolated Candida spp. were C. albicans (42.%), followed by C. parapsilosis (30.5%), C. glabrata (7.6%), C. tropicalis (6.4%), C. krusei (2.5%), C. lusitaine (2.5%), C. dubliniensis (2.1%), C. kefir (0.8%), and C. pelliculosa (0.4%). In 11 of the 236 episodes (4.5%), two Candida spp were cultured at the same time.The most common coinfection was C. albicans and C. parapsilosis. 112 of the 236 episodes (47.5%) was due to central venous catheter-related blood stream infection. 47.5% of these patients were receiving total parenteral nutrition at the time of candidemia. Concomitant coagulase negatif staphylococcus bacteremia was present in 50 of 236 candidemia episodes (21.2%). Of 236 isolates, 74 (31.4%) was cultured from peripheral blood culture only, 95 (40.3%) from central venous catheter only, 67 (28.4%) from both peripheral and central catheter blood culture.Trombocytopenia was noted in 117 episodes (49.6%) and neutropenia in 45 episodes (19.1 Of the 112 central venous catheter-related candidemia, 35 (31.3%) resulted in death within 30 days from the onset of candidaemia (Figure 1). In 49 (45.%) episodes of central venous catheter-related candidemia, catheter was not removed and 40% of these episodes resulted as death.Catheter removal, thrombocytopenia, total parenteral nutrion were found to be associated with increased mortality in children under 1 year of age (P < 0.001). Conclusion Clinicians must be aware of candidemia in children due to high risk of mortality. Disclosures All authors: No reported disclosures.

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