scholarly journals Medical Device-AssociatedCandidaInfections in a Rural Tertiary Care Teaching Hospital of India

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sachin C. Deorukhkar ◽  
Santosh Saini

Health care associated infections (HCAIs) add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. AsCandidamedical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associatedCandidainfections. Three commonly encountered medical device-associated infections (MDAI), catheter-associated urinary tract infection (CA-UTI), intravascular catheter-related blood stream infections (CR-BSI), and ventilator-associated pneumonia (VAP), were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate ofCandidarelated CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role ofCandidaspp.

Author(s):  
David D. M. Rosario ◽  
Anitha Sequeira

Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.


2017 ◽  
Vol 16 (3) ◽  
pp. 358-369 ◽  
Author(s):  
Hafsa Afroz ◽  
Md Fakruddin ◽  
Md Rana Masud ◽  
Kamrunnahar Islam

Objective: Hospital acquired infection (HAI) is a major concern in hospital settings.Methods: This study was conducted to evaluate the incidence of Hospital Acquired Infection (HAI), patient and hospital related factor, offending microorganism and their antimicrobial sensitivity. Data were collected prospectively with patients admitted during study period.Results and discussion: 9.4% respondents were found to develop HAI. 60% patients with more than 3 visitor, 11.9% patient with prior antibiotic therapy and 24% patient with underlying illness developed HAI. 14.6% routine operation case and 24.5% emergency operation case developed HAI. 17.1% patients with invasive device therapy whereas 3.8% patients without any device therapy developed HAI. 31.8% patients having immunosuppressive therapy and 37% patients with frequent transfer within hospital whereas only 6.9% patients without transfer developed HAI. Bacteria isolated from HAI cases were identified to be member of nine different genera. Klebsiella pneumoniae isolated from 33% HAI case, while Acinetobacter baumanii and Escherichia coli isolated from 13% case and Pseudomonas aeruginosa from 14% cases. Only colistin has sensitivity range from 76 to 100% while almost all other isolates were observed multi drug resistance (MDR).Conclusion: Comprehensive strategy should be undertaken to reduce risk of HAI.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.358-369


2021 ◽  
Vol 29 (01) ◽  
pp. 1-6
Author(s):  
Atta Ur Rehman ◽  
Muhammad Afzal Chowhan

Objective: To analyse experience of the surgical team in COVID-19 in a tertiary care hospital in Pakistan. Study Design: Analytical Observational study. Setting: Department of Surgery, Tertiary Care Hospital Sialkot, Pakistan. Period: March to September 2020. Material & Methods: After the permission of ethical review committee (ERC/12/2020), data was collected by all four groups surgeons, Resident and internees, paramedical staff and other staff of surgical teams. A simple, 6 question-questionnaire, manually typed, was distributed to all members willing to complete and return the questionnaire. Data was analyzed by using SPSS-23. Results: Majority (91.27%) of the surgical team members got satisfactory training to handle with Covid-19 Cases. The 80 % was in fear to contract the disease while working in isolation and COVID-19 wards and about (76%) were well adjusted to their newly assigned duties. About 85% of surgical team members experienced prolong duty hours (12 hours a day) related stress and similar percentage participated in the management of surgeries done during this period. Conclusion: Surgical Team participated and adapted to meet the newly assigned duties to lookafter the isolation and COVID-19 wards. Team members experienced stress and fear of contracting disease was a matter of concern. However, it has taken care of all trauma, life-threatening emergencies and oncological cases adhering to use of principles of use of PPEs.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S483-S483
Author(s):  
Sneha R ◽  
Arun Wilson ◽  
Anup R Warrier ◽  
Shilpa Prakash ◽  
Reima Elizabeth ◽  
...  

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


Author(s):  
Rituja Kaushal ◽  
Sanjeev Gupta ◽  
Aashish Saraogi ◽  
Sandhya Singh

Background: Ventilator associated pneumonia (VAP) is the deadliest hospital acquired infection in many low resource settings of developing countries. For VAP prevention, the concept of bundle of care was defined. Evidence based resources showed it enabled great successes in VAP prevention. It has been observed in clinical practice due to insufficient compliance, there is a need to address related issues in order to define easier-to-apply procedures.Methods: It is a retrospective analytical secondary data based study. It was conducted in a tertiary care hospital of Bhopal city.Results: T value of Mann Whitney/U test was found to be statistically significant and is indicating need of “Bundle Care Intervention” training for the prevention of increase in ventilator associated pneumonia rates in any health care setting.Conclusions: Expanded bevy of options related to infect


Author(s):  
Moonis Mirza ◽  
Farooq A Jan ◽  
Syed Hina Mumtaz ◽  
Fayaz Ahmad Sofi ◽  
Rauf Ahmad Wani

ABSTRACT Background Adverse events in hospitals are now widely agreed to be a serious problem, annually killing more people than breast cancer or AIDS. Aims: To study incidence of adverse events in admitted patients by current record review. Aims To study incidence of adverse events in admitted patients by current record review. Materials and methods A two-staged prospective study for a period of 1 year was carried out. Current records of inpatients were screened for adverse events. The adverse event was categorized as preventable or nonpreventable on the basis of World Health Organization (WHO) set confidence score of preventability. Results A total of 3150 patients were screened, among which 488 (15.5%) patients were screened positive for having adverse event. Readmission during last 12 months to any given healthcare for the same health condition (32.79%) was the most common adverse event seen. Hospital acquired infection/sepsis (26.64%) was the second most common adverse event seen. The 78% of adverse events presented with untoward outcome among which 81.8% of adverse events resulted in admission in wards, 4.33% adverse events were associated with death, 23.4% adverse events were associated with disability at discharge and 35.5% adverse events were associated with prolonged stay. A total of 67.4% of studied adverse events showed signs of healthcare team responsible for causing adverse events, among which 76.8% of adverse events occurred outside SKIMS before the index admission. A total of 71.3% of adverse events were categorized preventable. Conclusion Hospital acquired infection was found responsible for prolonged stay of the patients. Proper referral policy must be followed by the department of health services. How to cite this article Mirza M, Jan FA, Mumtaz SH, Sofi FA, Wani RA. A Study of Patient Safety with Special Reference to Incidence of Adverse Events taking Place in Patients in a Tertiary Care Hospital in North India. Int J Res Foundation Hosp Healthc Adm 2015;3(2):91-97.


2019 ◽  
Vol 16 (41) ◽  
pp. 452-456
Author(s):  
Purna Devi Shrestha ◽  
Sirjana Rai ◽  
Shobha Gaihre

Background: Hospital Acquired Infections are major challenge for low and middle income countries which have limited healthcare resources. Literature has explored the prevalence is high and practice is limited. This study aims to assess prevalence and preventive practices of Hospital Acquired Infection among health workers.Methods: A cross -sectional research design was carried out between Feb 2017 to May 2017 in National Trauma Center , Kathmandu. Census method was used to recruit 121 respondents and to find out prevalence. A structured questionnaire and observation checklist was used for data collection. Data was objectively analyzed in SPSS full version 21.Results: Prevalence of bacteria causing Hospital Acquired Infections was 11.83% in critical units. Among 95 specimen analysis, 53 specimen were isolated in critical units. The most common site of infection was the urinary tract 19 (35.8%) and bacteria causing nosocomial infection was Escherichia coli 28.30%. Culture plate was used to obtain environment samples, Out of 9 specimen analysis, Staphylococcus aureus was the most common isolated organism. Level of practice were significantly associated with education, training on HAI, work experience 0.019, 0.026, 0.027 respectively.Conclusions: The study found that prevalence of hospital acquired infection do exist in less percentage but preventive practices of HAI in majority of respondent were fair. Hence, there is a need to raise awareness as well as training on Hospital acquired Infection among health care workers.Keywords: Critical units; hospital acquired Infection; nosocomial Infection; practice; prevention.


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