A Study of Nosocomial Infections in Intensive Care Units of Local Tertiary Care Hospitals
Keywords:Gram-negative Enterobacteriaceae, Intensive care unit, Nosocomial infections, Ventilator-associated pneumonia
Introduction: It has been reported that the incidence of nosocomial infections in the intensive care unit (ICU) is about 2–5 times higher than in the general in-patient hospital population. The objectives of the present study were to determine the incidence of nosocomial infection, to identify possible risk factors for these infections, to clarify the distribution of the causative pathogens, and to evaluate the outcome of the infected patients in terms of length of ICU and hospital stay and mortality. Methods: This was a retrospective and analytical study. For classification of the different causative pathogens associated with nosocomial infections, all the microorganisms isolated on culture from each of the patients with confirmed infection according to the Centers for Disease Control and Prevention definitions were recorded and their relative frequency of isolation was determined as percentage. Bacterial isolates were identified by Gram stain, cultures on routine media and where necessary, selective media, and specific biochemical tests following standard protocols. Results: Nosocomial infections were in 28 patients. The most frequently diagnosed nosocomial infection was nosocomial pneumonia. A total of 39 pathogens were isolated on culture and accounted for the nosocomial infections in 28 patients. Some infections were polymicrobial. Gram-negative Enterobacteriaceae were the most frequently isolated pathogens. There was no statistically significant difference between the hospital mortality rates among the patients with and without nosocomial infection. Conclusion: Gram-negative Enterobacteriaceae, as a group, were the most frequently isolated pathogens, while Pseudomonas aeruginosa was the single most frequent causative organism. The acquisition of nosocomial infections in the ICU resulted in significantly increased length of ICU and hospital stay, but did not result in statistically significant increase in ICU or hospital mortality. These findings can now be utilized toward planning a surveillance program for nosocomial infection in our ICU setting as a first step toward a better infection control strategy.
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Copyright (c) 2021 Sanjay Agrawal, Rahul Kewal Kumar
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