Critical Care Innovations (Jun 2022)

Prevalence and outcome of infections in intensive care units of a tertiary care hospital in north India.

  • Samiullah Sami Malik,
  • Muzaffar Maqbool,
  • Asma Rafi ,
  • Najma Kokab

DOI
https://doi.org/10.32114/CCI.2022.5.2.20.28
Journal volume & issue
Vol. 5, no. 2
pp. 20 – 28

Abstract

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INTRODUCTION: Infection is a major cause of morbidity and mortality in Intensive Care Units (ICUs), more so in resource limited ICUs of low and lower-middle income countries. However relatively little information is available about epidemiology and outcome of such infections in our part of the world. The point was to provide information about the prevalence and outcome of primary and secondary (nosocomial) infections in ICUs. MATERIAL AND METHODS: 257 adult patients admitted in medical and surgical ICUs over a period of 9 months were enrolled in the study. Patients fulfilling sepsis 3 criteria were categorized under “prevalence of the infections” and patients who developed infections after 48 hours of admission in ICUs were categorized under “secondary (nosocomial) infections”. Sequential Organ Failure Assessment score (SOFA score) was calculated at admission and after 72 hours of ICU stay. The patients were followed for 30 days. RESULTS: Patients were distributed in two groups: 153 (59.5%) medical ICU and 104 surgical ICU patients. Prevalence of primary infection was significantly higher in medical ICU patients (p value < 0.05). A total of 93(60.8%) patients in medical ICU and 50(48.1%) patients in surgical ICU were admitted as primary infections (p value < 0.001). Secondary (nosocomial) infections occurred in 30 (19.6%) patients in medical ICU and 15 (14.4%) patients in surgical ICU (p-value 0.283). The average length of stay was 14 days in patients with nosocomial infections and 3.5 days for patients without secondary infections (p-value < 0.001). Out of total of 188 infected patients, 80 (42.5%) died whereas 17 (24.6%) of the 69 patients without infection expired (p-value 0.008). 112 patients with mean SOFA score of 11.35 ± 2.71 expired while as 145 patients with mean SOFA score of 5.84 ± 1.92 survived (p value < 0.001). CONCLUSIONS: The prevalence of infections was more in medical ICU than in surgical ICU. The nosocomial infections significantly increase the average length of stay in ICUs. Mortality was significantly more in patients admitted with infection in Intensive Care Units. The higher the SOFA score, greater the mortality.

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