ABSTRACT

Background: Infections acquired within a hospital setting, commonly called healthcare-associated infections (HAIs), are nosocomial infections that are typically absent or in an incubation phase upon admission. The study aimed to determine the prevalence of device-associated HAI and the factors affecting HAI in the Medical Intensive Care Unit (MICU).

Methods: A prospective observational study was conducted, including patients admitted to the MICU of a tertiary care medical centre from March 2020 to March 2023. The patient’s total ventilator days, catheter days, central line days, and development of HAI, according to the definition of surveillance, were recorded for each patient. Rates for device-associated infections and device utilisation ratios (DURs) were calculated. Statistical analysis involved descriptive statistics, Kaplan-Meier curve analysis with the Log Rank test, and logistic regression analysis to identify factors associated with HAI.

Results: 386 patients were included in the study, of which 52 (13.47%) developed HAI. The DUR for ventilators, catheters, and central lines were found to be 0.502, 0.949, and 0.545, respectively. Ventilator-associated pneumonia (VAP) rate was 16.07 per 1000 ventilator days, the catheter-associated urinary tract infection (CAUTI) rate was calculated to be 1.64 per 1000 catheter days, and the central line-associated bloodstream infection (CLABSI) rate was 1.91 per 1000 central line days. On multivariate analysis, the length of stay [adjusted odds ratio (AOR), 1.292; 95% CI: 1.200-1.391], and history of hospitalisation in the past 90 days (AOR, 6.556; 95% CI: 2.619-16.411) were also found to be independent predictors for HAI.

Conclusion: Our institution has lower rates of CAUTI and CLABSI. However, the VAP rate is higher than in studies conducted in an Indian setting. Hence, adopting the INICC multidimensional approach can address and reduce our VAP rate.