Emergency Medicine: Open Access
Open Access

Abstract

Prospective Evaluation and Mortality Outcome of Nosocomial Infections in Medical Intensive Care Unit at Tertiary Care Teaching Centre in Mumbai

Rakesh Bhadade

Background
Hospital acquired infections are a worldwide phenomenon and infection rates in ICU’s have been documented to be ranging from 12% to 45%.

Methods and material
To study epidemiology of nosocomial infections and it’s clinical outcome.

Study design and setting
It is a prospective observational study; carried out in the Medical intensive care unit (MICU) of a tertiary care teaching hospital.

Results and conclusion
205 patients developed nosocomial infection. The commonest nosocomial infections developing in MICU were Ventilator Associated Pneumonia (VAP); hospital acquired pneumonia followed by urinary tract infection. 94.1% isolates were Gram-negative and Gram-positive contributing to 2.5%, of which most common organisms isolated were Klebsiella, Acinetobacter and E. coli. 93.4% of blood stream infections were associated with intravenous lines, 68.1% of pneumonia with intubation, 91.7% of UTIs were associated with urinary catheter. As number of risk factors increase, like duration of mechanical ventilation, prolonged ICU stay (60.0%), increasing age, and number of organs failed, mortality increased significantly. Sensitivity of E. coli isolates to carbapenams, polymyxin was 100%. Klebsiella and Acinetobacter showed a maximum sensitivity to carbepenem, polymyxin followed by piperacillin-tazobactum. 75.1% of patients with nosocomial infections improved and mortality in current study was 30.3%.