Active surveillance culture in a critical care unit of a tertiary care hospital of West Bengal, India: a prospective study

ABSTRACT

Background: Hospital-acquired infections are a common and serious public health problem and their management and control are essential to minimize hospital-related morbidity and mortality. The aim was to acquire the base line data regarding prevalence of Multi Drug Resistant (MDR) organism in a tertiary care institution and to help in ensuring proper practice guidelines like contact isolation, cohorting and sterile barrier precaution. The study design was an observational descriptive hospital based cross sectional study.Methods: The study was conducted in a critical care unit of a tertiary care hospital for a duration of 6months. Patients with the age more than 18yrs, duration of stay more than 48hrs were included in the study. Categorical data are expressed in percentages.Results: In the study 111 patients more than 18 yrs of age were enrolled of which 68 were male and 43 females. The sample collected from the axillary site were 110, nasal site 108, urine 96 and respiratory site 95. The culture positivity for pathogenic organisms were maximum for axillary site (95.5%) followed by nasal site (83.33%), respiratory site (36.8%) and urine (26%). Of all the organisms isolated multidrug resistance were as follows MRSA 63% and MSSA 37% (of all S. aureus), MR CoNS 41.32% (of all CoNS), ESBL producer 22.2% and carbapenemase producer 22.2% (of all Klebsiella species), ESBL producer 37.5% and carbapenemase producer 31.26% (of all E. coli), non albicans Candida 57.14% (of all Candida species).Conclusions: Early identification of the causative pathogen in nosocomial and community-acquired infection is crucial for initiating the correct antibiotics as well as preventing further spread.