Agarwal Reshu, Mohapatra Sarita, Rath Girija Prasad, Kapil Arti
Senior resident, Department of Microbiology, AIIMS, New Delhi, India.
Assistant Professor, Department of Microbiology, AIIMS, New Delhi, India.
J Clin Diagn Res. 2017 Jul;11(7):DC01-DC04. doi: 10.7860/JCDR/2017/26681.10146. Epub 2017 Jul 1.
Health Care Associated Infections (HCAI) are frequent complications in neurosurgery. There is limited data available on the incidence and burden of HCAI in neurosurgical patients of Southeast Asian region.
To identify various HCAIs, associated aetiological agents and their antimicrobial susceptibility pattern among the patients admitted in the neurosurgery unit.
An observational prospective study was carried out for three months duration on all neurosurgical patients admitted to a tertiary-care center. The site-specific nosocomial infection rates and device utilization ratios were calculated. Data on demographic profiles, invasive procedures, HCAI, isolated microorganisms and antimicrobial susceptibilities were recorded. Statistical analysis of all the variables was done. The association between categorical variables was assessed by Chi-square/Fisher-exact test. Continuous variables such as infected and non-infected were compared by Wilcoxon rank-sum test. A p-value of less than 0.05 was considered significant.
A total of 330 patients with 4054 patient-days were analysed for HCAI. Twenty-two HCAIs were identified in 21 patients. The overall rate of HCAI was 6.67% and 5.42 per 1000 patient-days. Urinary Tract Infection (UTI) was most common (71.4%) followed by Laboratory Confirmed Blood-Stream Infection (LCBI) (28.5%) and pneumonia (4.7%). No central line-associated blood stream infection was identified. and were the most common organisms causing UTI and LCBI. All the isolates (100%) were found to be multidrug resistant.
This study generates a baseline data for records of device-associated infection in neurocritical care patients, which will further help monitoring its trend of infection and antimicrobial resistance pattern. Moreover, it will help in the formulation of the antibiotic policy and the preventive measures which may reduce morbidity and mortality.
医疗保健相关感染（HCAI）是神经外科常见的并发症。关于东南亚地区神经外科患者中HCAI的发病率和负担的数据有限。
确定神经外科病房收治患者中的各种HCAI、相关病原体及其抗菌药物敏感性模式。
对一家三级医疗中心收治的所有神经外科患者进行了为期三个月的前瞻性观察研究。计算了特定部位的医院感染率和设备使用率。记录了人口统计学资料、侵入性操作、HCAI、分离出的微生物和抗菌药物敏感性数据。对所有变量进行了统计分析。分类变量之间的关联通过卡方检验/费舍尔精确检验进行评估。通过Wilcoxon秩和检验比较感染组和非感染组等连续变量。p值小于0.05被认为具有统计学意义。
共分析了330例患者，4054个患者日，以确定HCAI情况。在21例患者中发现了22例HCAI。HCAI的总体发生率为6.67%，每1000个患者日为5.42例。尿路感染（UTI）最为常见（71.4%），其次是实验室确诊血流感染（LCBI）（28.5%）和肺炎（4.7%）。未发现中心静脉导管相关血流感染。大肠埃希菌和肺炎克雷伯菌是导致UTI和LCBI最常见的病原体。所有分离株（100%）均被发现对多种药物耐药。
本研究为神经重症监护患者设备相关感染记录生成了基线数据，这将有助于进一步监测感染趋势和抗菌药物耐药模式。此外，它将有助于制定抗生素政策和预防措施，从而降低发病率和死亡率。
