A point prevalence survey of health associated infections and antimicrobial use in a public health institution in Trinidad

ABSTRACT

Objective: The point prevalence survey is a validated tool for measuring the quality of prescribing in the hospital setting. The objectives were to estimate the prevalence of hospital acquired infections, to assess the antimicrobial agent prescribed and determine if prescribers followed existing evidence-based antimicrobial policies subsequent to diagnosis of infection in patients. Design and Methodology: Day-of-survey records of patients in the intensive care unit and medical/surgical wards were examined at the institution, retrospectively. The extracted clinical data were recorded on the standardized data collection instruments (hospital, ward and patient forms) and analysed. Results: Of the 130 patients surveyed, 30 had an infection which occurred within 48 hours of admission. The most commonly reported infection type was urinary tract infections, evident in 9 (30.0%) patients, caused by Escherichia coli in 7 patients and Klebsiella pneumonia in 2 patients. Out of the 30 patients, 10 (33.3%) were awaiting laboratory reports at the time of the survey. Resistance was noted for Staphylococcus aureus and Escherichia coli, both of which were seen in 2 patients and Enterococcus spp. in 1 patient. The antimicrobial agent selected to treat these microorganisms should have been queried. Conclusions: Results of this survey imply that public health surveillance and prevention activities should be implemented to address appropriate treatment of hospital acquired infections. Recommendations to minimize the risk of resistance include improving the availability of alcohol-based hand rub, the provision of single room and isolation capacity, antimicrobial guidelines for treatment of infection, judicious prescribing and proper surveillance of prescribed antimicrobials.