Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit.
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Date
2016-04
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Abstract
Background: Nosocomial infections (NIs) in the postoperative period not only increase morbidity and
mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective
study was undertaken to (a) evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b)
identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac
Surgical Intensive Care Unit (CSICU). Patients and Methods: After ethics committee approval, the CSICU
records of all patients who underwent cardiovascular surgery between January 2013 and December 2014
were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and
their antibiotic resistance, length of CSICU stay, and patient‑outcome were determined. Results: Three
hundred and nineteen of 6864 patients (4.6%) developed NI after cardiac surgery. Lower respiratory tract
infections (LRTIs) accounted for most of the infections (44.2%) followed by surgical‑site infection (SSI,
11.6%), bloodstream infection (BSI, 7.5%), urinary tract infection (UTI, 6.9%) and infections from combined
sources (29.8%). Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent
pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram‑negative bacteria isolated
from different sources were found to be highly resistant to commonly used antibiotics. Conclusion: The
incidence of NI and sepsis‑related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory
tract was the most common site of infection and Gram‑negative bacilli, the most common pathogens after
cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.
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Keywords
Cardiac Surgical Intensive Care Unit, Microbiological profile and antibiotic resistance patterns, Nosocomial infection
Citation
Sahu Manoj Kumar, Siddharth Bharat, Choudhury Arin, Vishnubhatla Sreenivas, Singh Sarvesh Pal, Menon Ramesh, Kapoor Poonam Malhotra, Talwar Sachin, Choudhary Shiv, Airan Balram. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit. Annals of Cardiac Anaesthesia. 2016 Apr; 19(2): 281-287.