Prevalence and Risk Factors of nosocomial infection in intensive care unit patients

Ananya Reddy; V. Bose; S. Sharma

doi:10.5281/zenodo.22812779

Authors

Ananya Reddy Division of Clinical Bacteriology, Brahmaputra Research Center for Clinical Bacteriology Author https://orcid.org/4432-7343-8380-0135
V. Bose Department of Clinical Medical Microbiology, Tigris Academy of Medical Microbiology Author https://orcid.org/1019-3477-0940-500X
S. Sharma Department of Medical Microbiology, Mackenzie Research Center for Clinical Bacteriology Author https://orcid.org/2621-1406-2255-013X

DOI:

https://doi.org/10.5281/zenodo.22812779

Keywords:

Nosocomial infection, Intensive care unit, Risk factors, Prevalence, Ventilator-associated pneumonia

Abstract

Graphical abstract

Background: Nosocomial infections remain among the leading preventable complications of critical illness, disproportionately affecting intensive care unit (ICU) patients exposed to invasive devices, prolonged ventilation and impaired host defences. Local prevalence and risk-factor data are needed to target infection-control resources.

Methods: A prospective observational study was conducted over 12 months in a mixed medical-surgical ICU. Patients admitted for over 48 hours were screened daily using CDC/NHSN definitions for ventilator-associated pneumonia (VAP), central-line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI) and surgical-site infection. Multivariable logistic regression identified independent risk factors for infection.

Results: Of 412 patients, 118 (28.6%) developed nosocomial infection; VAP was commonest (41.5% of episodes), followed by CLABSI (23.7%), CAUTI (19.5%) and surgical-site infection (15.3%). Gram-negative organisms, led by Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa, predominated, with substantial multidrug resistance. Independent predictors were mechanical ventilation >5 days (aOR 4.2), central line >7 days (aOR 3.1), APACHE II >=20 (aOR 2.8), ICU stay >10 days (aOR 2.6) and prior antibiotics (aOR 1.9), all p<0.05. Infected patients had higher mortality (34.7% vs 14.1%, p<0.001).

Conclusion: Nosocomial infection affected over a quarter of this cohort and was independently linked to device duration, illness severity, stay length and prior antibiotics, supporting device-minimisation bundles, stewardship and continuous surveillance as priorities.

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