Surveillance of Medical Device - Associated Infections in a Tertiary Care Teaching Hospital, Indore, India

Ventilator associated pneumonia (VAP), intravascular catheter-related blood stream infections (CR-BSI) and catheter associated urinary tract infection (CA-UTI) are major medical device-associated infections that pose the greatest threat to patient safety. As surveillance of Healthcare-associated infections (HAI), so as to define the magnitude and nature of the problem, is the primary step towards reducing the risk of infection in vulnerable hospitalized patients, in the present study, surveillance of medical device associated infections (MDAI) was conducted.  Surveillance of three common medical device-associated infections like CA-UTI, CR-BSI, and VAP was done. For the purpose of surveillance the definitions of CDC’s National Nosocomial Infections Surveillance (NNIS) system criteria, were used.  The overall rate of MDAI was 6.8 cases per 1000 device associated days. CAUTI (6.9%) was the most common MDAI whereas the rate of CR-BSI (8.1 cases per 1000 catheter days) was high among all MDAI studied. Klebsiella spp. (33.6%) followed by E. coli (21.3%) and Pseudomonas spp. (14.7%) were pathogens from MDAI. Candida spp. was isolated from 15 (11.4%) cases. Pseudomonas spp. (50%) was the major pathogen isolated from VAP cases. Klebsiella spp. was commonest isolate from CA-UTI and CR-BSI.   The cost of MDAI is substantial, both in terms of morbidity and in terms of financial resources expended. To improve patient outcome and reduce health-care costs, strategies should be implemented to reduce the incidence of these infections. Surveillance is an effective tool that can be used to improve infection prevention and control practices.

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