Trend of Device-associated HAIs in an adult ICU of a tertiary care hospital: a need to revamp preventive strategies

Device associated Infections (DAIs) like Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infections (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in ICUs.

The study aims to elucidate their trends in an adult Intensive Care Unit (ICU).

Over a period of 21 months, monthly VAP, CLABSI and CAUTI rate and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. All cases of VAP, CLABSI and CAUTI during these 21 months were included. Monthly hand hygiene compliance rates were assessed during latter period of the study by direct observation method.

Nosocomial DAI rate was 49.38 DAI/1000 ICU days. The overall rates of CAUTI, CLABSI and VAP were 17.38, 26.85, 21.08 per 1000 device days and device utilization ratios were 0.99, 0.61 and 0.02 respectively.

The institute had high DAI rates in comparison to other studies from the same city. Declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. This establishes a baseline data and underscores the need for focused HIC for maximal impact on patient outcome.