Hospital Practices and Research

Abstract Background: Hospital-acquired infections (HAIs), particularly device-associated infections (DAIs) in ICUs, pose a significant global health burden, especially in low- and middle-income countries.
Objectives: This study aims to estimate the HAI burden by analyzing DAI rates and resistance patterns in ICU settings, contributing to evidence-based infection control strategies.
Methods: We conducted a six-month prospective observational study in the adult ICU of GTBH (July–December 2024), focusing on patients with DAIs. Incidence and device utilization rates were calculated using CDC-standardized metrics based on device and patient days.
Results: Out of 286 patients, 40 developed a total of 62 DAIs, comprising 25 cases of ventilator-associated pneumonia (VAP) (40.3%), 19 cases of catheter-related bloodstream infections (CLABSI) (30.65%), and 18 cases of catheter-associated urinary tract infections (CAUTI) (29.03%). VAP had the highest cumulative infection rate (22.6%), followed by CLABSI (21%) and CAUTI (10.8%). Acinetobacter baumannii was the dominant isolate in VAP cases, Klebsiella pneumoniae and Enterobacter spp. were predominant in CLABSI cases, and non-albicans Candida was the leading pathogen in CAUTI cases. Significant antimicrobial resistance was observed, especially among Acinetobacter and Pseudomonas species. Notably, the case fatality rate among DAI patients reached 57.5%.
Conclusion: In conclusion, our surveillance study highlights a substantial burden of DAIs in the ICU, with VAP being the most prevalent. The dominance of multidrug-resistant pathogens and the striking 57.5% fatality rate emphasize the urgent need for robust infection control, tailored stewardship programs, and continuous local epidemiological monitoring.

Abstract Background: Device-Associated Infections (DAIs) pose significant challenges in healthcare settings, leading to increased morbidity, mortality, and healthcare costs. Understanding the impact of the COVID-19 pandemic on DAIs and device utilization rates is crucial for optimizing infection control practices and enhancing patient safety.
Objectives: This study aims to elucidate the shifts in infection rates, specifically CAUTI, VAP, and CLABSI in a tertiary care centre before and after the onset of the global pandemic.
Methods: In this retrospective study, we analysed trends in DAIs and device utilization rates before (October 2019 - March 2020) and after (August 2021 - January 2022) the COVID-19 pandemic. Data on urinary catheter days, central line days, ventilator days, and rates of Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infection (CLABSI), and Ventilator-Associated Pneumonia (VAP) were collected from medical records.
Results: According to the findings of the present study, fluctuations in CAUTI, CLABSI, and VAP rates pre- and post-pandemic, with no significant difference in infection rates between the two periods (P >0.05) were observed. There was a notable increase in urinary catheter days post-pandemic, accompanied by reductions in ventilator days and central line days. The urinary catheter utilization ratio substantially increased post-pandemic, while ventilator and central line utilization ratios showed slight declines.
Conclusion: This study highlights the dynamic nature of DAIs and device utilization rates in the wake of the COVID-19 pandemic. Implementing evidence-based protocols and continuing research in infection control practices are essential for optimizing healthcare delivery and enhancing patient safety in the post-pandemic era.

Abstract Background: Hospitals in the national capital were staring at the rising cases of pink eye, more than 100 of which had been daily hitting the outpatient departments of major hospitals in Delhi during the month of July 2023. Outbreaks of Conjunctivitis are common globally, with people across all age and socio-economic status getting affected.
Objectives: The aim of the study was to do a molecular analysis on the etiology in cases of epidemic keratoconjunctivitis.
Methods: A multicentric prospective observational study was carried out during the outbreak of conjunctivitis in Delhi. The clinical samples were processed by polymerase chain reaction for common etiology of acute keratoconjunctivitis.
Results: Adenoviral etiology was witnessed in 8.3% of cases, while no other bacterial or viral etiology could be documented.
Conclusion: Studying the etiological pattern of any outbreak of infections can provide insights into the prevalent transmissible pathogens and help in future preparedness.

Abstract Background: 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 intensive care units (ICUs).
Objectives: The study aims to elucidate their trends in an adult ICU.
Methods: Over 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. In addition, monthly hand hygiene compliance rates were assessed during the latter period of the study by direct observation method.
Results: Nosocomial DAI rate was 49.38 DAI/1000 ICU days. CAUTI, CLABSI, and VAP rates were 17.38, 26.85, 21.08 per 1000 device days, and device utilization ratios were 0.99, 0.61, and 0.02, respectively.
Conclusion: The institute had high DAI rates in comparison to other studies from the same city. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. Thus, it establishes baseline data and underscores the need for focused HIC to maximize patient outcomes.

Abstract Background: In December 2019, in Wuhan, China; a new coronavirus emerged that had not been previously identified in humans. Hence is crucial to characterize the infection risk among infected health care workers (HCWs), being responsible for secondary transmission to patients, and others.
Objectives: The current study aimed to assess the disease burden among the front-line warriors and efficiently planned the preventive and management strategies for such infections.
Methods: HCWs with clinical suspicion of COVID-19 infection, who reported to Fever Clinic for possible diagnosis by Truenat testing, were enrolled through a self-reporting Risk Assessment form. An oropharyngeal swab was subjected to Truenat testing based on the principle of Real time reverse transcription polymerase chain reaction (RT-PCR).
Results: Doctors comprised 60% of our HCWs. Eighty-three percent of the HCWs under study reported either the presence of BCG scar or gave a history of BCG immunization at birth. The maximum number of HCWs (29.16%) took Hydroxychloroquine prophylaxis for four weeks. Seventy-four percent of the HCWs affirmed the use of personal protective equipment (PPE) at the time of exposure. The most common mode of infection reported was the exposure to COVID-19 patients. Fever was the most common reported symptom. Truenat was positive in 9 of 100 HCWs who were tested, giving an infection rate of 9%.
Conclusion: The study provides insights into the burden of COVID-19 infection among HCWs, and guides us to evaluate and plan our preventive measures and management strategies for such infections.