A Study on Device Associated Infections in the Adult Intensive Care Unit at a Tertiary Care Hospital

The surveillance of Device associated infections in ICUs can reduce incidence of Nosocomial infections (NIs), healthcare cost & a better control of infections. Aims & Objectives: To know the occurrence of device associated infection rate in ICU and to know the bacterial profile of various devices associated infections. Materials and Methods: This study was conducted between October 2011 to May 2012 in a six bedded adult ICU. A total of 1000 specimens of endotracheal aspirate; catheterized specimen urine and intravenous blood were collected from 567 eligible patients (CDC criteria). Identification of pathogens, antibiotic susceptibility testing was carried out as per standard guidelines. Extended Spectrum β-Lactamase (ESBL), Inducible AmpC β-Lactamase, Plasmid-mediated AmpC production, and Metallo-βLactamase (MBL) were tested for Gram negative bacilli by Combined disc diffusion method, Disk antagonism, Modified three-dimensional test, and Modified Hodge Test (MHT) respectively. Methicillin resistant Staphylococcus aureus (MRSA) & inducible clindamycin resistant (D-test) were tested for Gram positive bacteria. The data were analysed for determining DAI rate for Ventilator Associated Pneumonia (VAP), Catheter Associated Urinary Tract Infections (CA-UTI) & Central Line Associated Blood Stream Infections (CLA-BSI) using CDC guidelines. Results: DAI rates for VAP, CLA-BSI and CAUTI were 38.7, 7.6 and 1.47 /1000 device days respectively. Acinetobacter baumannii and Pseudomonas aeruginosa were predominant isolates. MBL (85%) & ESBL (62%) were most common resistance mechanisms for Acinetobacter baumannii and Pseudomonas aeruginosa respectively. Conclusion: VAP was most common infection. Multidrug resistant (MDR) A.baumannii & Ps.aeruginosa were predominant organisms. Most common resistance mechanisms were MBL for A.baumannii & ESBLs for Ps.aeruginosa.