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Background: Hospital-acquired infections are a common and serious public health problem and their management and control are essential to minimize hospital-related morbidity and mortality. The aim was to acquire the base line data regarding prevalence of Multi Drug Resistant (MDR) organism in a tertiary care institution and to help in ensuring proper practice guidelines like contact isolation, cohorting and sterile barrier precaution. The study design was an observational descriptive hospital based cross sectional study.Methods: The study was conducted in a critical care unit of a tertiary care hospital for a duration of 6months. Patients with the age more than 18yrs, duration of stay more than 48hrs were included in the study. Categorical data are expressed in percentages.Results: In the study 111 patients more than 18 yrs of age were enrolled of which 68 were male and 43 females. The sample collected from the axillary site were 110, nasal site 108, urine 96 and respiratory site 95. The culture positivity for pathogenic organisms were maximum for axillary site (95.5%) followed by nasal site (83.33%), respiratory site (36.8%) and urine (26%). Of all the organisms isolated multidrug resistance were as follows: MRSA 63% and MSSA 37% (of all S. aureus), MR CoNS 41.32% (of all CoNS), ESBL producer 22.2% and carbapenemase producer 22.2% (of all Klebsiella species), ESBL producer 37.5% and carbapenemase producer 31.26% (of all E. coli), non albicans Candida 57.14% (of all Candida species).Conclusions: Early identification of the causative pathogen in nosocomial and community-acquired infection is crucial for initiating the correct antibiotics as well as preventing further spread.
RESUMO
BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.