Healthcare associated infections: A menace-role of management at a multi-super-specialty hospital in North West Region of Delhi

Background: Healthcare-associated infections (HAIs) are usually related to a procedure or treatment used to diagnose or treat the patient's initial illness or injury. Aim: To find and compare the incidence of HAI in different Intensive Care Units (ICU's) of Hospital A. To show a correlation, between HAI with mortality, morbidity and average length of stay (ALOS). Materials and Methods: The study was carried out at three ICU's of Hospital A in North-West Delhi-Surgical Intensive Care Unit (SICU), Respiratory Intensive Care Unit (RICU) and Medical Intensive Care Unit (MICU). All patients admitted were followed from admission to 2 days after discharge from the ICU during a period of January 2010-December 2011-December-2012. The total sample amounted to 35,582 patient device days-13,051 for 2010 and 11,659 for 2011 and 10,872 for 2012. Continuous training was there from 2011 onwards for bundle approach and hand hygiene monitoring. Results: The rate of ventilator-associated pneumonia (VAP) from 55.93 per 1000 device days to 7.91 per 1000 device days from 2010 to 2012, catheter-associated urinary tract infection (CAUTI) decreased from 6.33 per 1000 device days to 1.43 per 1000 device days but catheter-related bloodstream infection (CRBSI) increased from 8.46 per 1000 device days to 21.80 per 1000 device days. There is a significant correlation between mortality and HAI P value 0.03 with no significant correlation between morbidity and HAI P value 0.74 also no significant correlation in ALOS and HAI P value 0.17. Conclusion: The trend in VAP and CAUTI in 3 ICU's from 2010 to 2012 shows a decreasing trend, the trend of CRBSI in 3 ICU's from 2010 to 2012, which shows a decreasing trend in MICU with no trend in SICU and RICU. There is a significant correlation between mortality and HAI with no significant correlation between morbidity and HAI also no significant correlation in ALOS and HAI.