Publication: Health Care Associated Infection and Trend of Antimicrobial Resistance in Tertiary Care Hospital -A Study in Low Income Setting
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are
among the most serious public health problems and overall estimate indicates that at
any point, over 1.4 million people are suffering from health care associated infection
globally. According to the WHO report, the frequency of nosocomial infection is 10%
in South East Asia where as 7% in developed countries. The increasing trend of AMR
in pathogenic bacteria leads to complication to treat HAIs and failure in treatment
and rise in mortality.
Objective
The study was conducted with the objective of to explore the incidence of different
types of HAIs and AMR pattern in the patients admitted in a tertiary care hospital.
Method
The cross-sectional study was conducted at the tertiary care hospital and the patient
who are one year or older and admitted for more than 48 hours were included
in this study. The criteria for classification of HAIs were adapted from Centers for
Disease Control. All the samples were collected then antibiotic sensitivity testing
was conducted according to CLSI standards. Data were collected using a structured
data collection form. Data were entered in EpiData software and analyzed using SPSS
version 22.
Result
Among 2326 patients, female was slightly higher than male patients, where 77 (3.3%)
patients experienced at least one episode of HAIs. The surgical site infection (71.42%)
is the most common infection followed by Catheter Associated Urinary Tract Infection
(18.18%) and Health Care Associated Pneumonia (6.49%). Mean hospitalization days
is higher with HAI (14.5 days) compared to non-HAI (6.6 days). Out of 909 specimens,
urine, sputum and blood were higher in numbers, where 217 bacterial isolates were
isolated with Escherichia coli (83 isolates) was the most common bacteria. It is found
that Escherichia coli bacterial isolates were resistance to most common antibiotics.
Conclusion
The study concludes that surgical site infection is the most common healthcare-
associated infection and Escherichia coli is the most common bacteria responsible
for HAIs. Further, surgical site infection being the most common infection, there is an
urgent need to take effective infection prevention and control prevention.
KEY WORDS
Antimicrobial resistance, Healthcare-associated infections, Surgical site infection
Description
Shrestha R,1,2 Koju P,2 Xinliang Liu,3,4 Maharjan B,5 Madhup S,6 Shah P,3 Hao Li3
Department of Pharmacology,
Kathmandu University School of Medical Sciences,
Dhulikhel, Kavre.
2Pharmacovigilance Unit/ Research and Development Division,
Dhulikhel Hospital, Kathmandu University Hospital,
Dhulikhel, Kavre.
3School of Health Sciences /Global Health Institute,
Wuhan University, No 299 Bayi Road,
Wuhan, 430071, China.
4School of Health Sciences,
Faculty of Biology, Medicine and Health,
The University of Manchester, Oxford Road,
Manchester, M13 9PL, United Kingdom.
5Department of Infection Prevention and Control,
Dhulikhel Hospital, Kathmandu University Hospital,
Dhulikhel, Kavre.
6Department of Microbiology,
Dhulikhel Hospital, Kathmandu University Hospital,
Dhulikhel, Kavre
Keywords
Antimicrobial resistance, Healthcare-associated infections, Surgical site infection