| ORIGINAL ARTICLE |
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| Year : 2014 | Volume
: 2
| Issue : 2 | Page : 38-41 |
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Impact of an intensive surveillance on central line associated blood stream infections at an Indian trauma center
Vibhor Tak1, Purva Mathur1, Subodh Kumar2, Babita Gupta3, Amit Gupta2, Sumit Sinha4, Deepak Gupta4, MC Misra2
1 Department of Laboratory Medicine, JPNA Trauma Centre, AIIMS, New Delhi 110029, India
2 Department of Surgery, JPNA Trauma Centre, AIIMS, New Delhi, India
3 Department of Anaesthesiology, JPNA Trauma Centre, AIIMS, New Delhi, India
4 Department of Neurosurgery, JPNA Trauma Center, AIIMS, New Delhi, India
Correspondence Address:
Purva Mathur
Department of Laboratory Medicine, JPNA Trauma Centre, AIIMS, New Delhi 110029
India
 Source of Support: None, Conflict of Interest: None  | Check |
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Background: Central line associated blood stream infections (CLA-BSIs) are a leading cause of health care associated infections. There is paucity of data on the actual magnitude of CLA-BSIs in most hospitals of developing countries due to lack of surveillance. This study reports the impact of an intensive surveillance, training and feedback on the rates of CLA- BSIs at an Indian trauma center.
Methods: The study was conducted at a level 1 trauma center from June 2010 to January 2013. The clinical details of all patients and microbiology culture reports who were admitted for more than 48 h were recorded in a pre-designed pro forma. These details were further entered in an automated software based upon CDC NHSN's definitions of device associated infections. The CLA-BSI rates in a previous pilot study in 2010 were found to be very high. Intensive surveillance, education and training drive was initiated along with better hand hygiene and device care as a part of hospital infection control measures. Results: During the study period, a total of 2969 patients were followed up for CLA-BSIs. These patients amounted to a total of 27,394 ICU days and 15,443 CVC days. A total of 93 episodes of CLA-BSI occurred during the study, amounting to a CLA-BSI rate of 6.02/1000 CVC days. Staphylococcus aureus (27; 27.5%) was the most common isolate. A total of 101 episodes of secondary BSIs were also observed during the study. Of these, 70 (69%) were secondary to VAP, 18 (18%) were secondary to wound infections and 13 (13%) were sec- ondary to UTI. Of the 92 patients who accounted for the 93 episodes of CLA-BSIs, a total of 20 (21.7%) had a fatal outcome.
Conclusions: Thus, with the help of the intensive surveillance, using this software, we have been able to monitor the impact of training, surveillance and interventions on the rates of CLA-BSI, which have reduced from 27.6 to 6/1000 CVC days within a span of 2 years at our institute. Although these measures require a dedicated team effort, they are easy and cost effective to implement and can reduce device associated infections across all types of health care facilities. |
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