Clinical and microbiological profile of healthcare associated infection in a tertiary care hospital in north-eastern India

Background: Data from northeast India regarding health care associated infections (HAI) is limited. Objective: To determine the incidence, determinants, clinical and microbiological profile of healthcare associated pneumonia and urinary tract infection (UTI). Methods and material: Prospective, observational study was conducted in 150 patients with HAI, aged >= 18 years, selected randomly. HAI was defined by CDC criteria. Controls comprised of 150 age and sex matched patients without HAI. Data was analysed using SPSS-17.0 and p value <0.05 was considered significant. Results: Mean age was 54.3 +/- 17.2 years with male: female ratio of 3: 2. Most patients (66%) were aged >= 50 years. Overall incidence of HAI was 11.06%. Most common causative organisms for healthcare associated UTI and pneumonia were E. coli (34.8%) and Klebsiella (37.7%) respectively. Compared to controls, patients with HAI had significantly higher co-morbidities (57.3% vs. 18.7%, p < 0.001); increased use of invasive devices (p < 0.05); increased use of quinolones, piperacillin-tazobactam, carbapenem; longer stay in the ICU (12.04 vs. 6.02 days, p < 0.01) and increased in-hospital mortality (27.3% vs. 5%, p < 0.01). Conclusion: HAI are more common in patients aged >= 50 years, having co-morbidities, resulting in increased hospital stay and poorer outcomes. The incidence of HAI and isolation of multidrug resistant organisms are lower than other studies. (c) 2018 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of Indian Journal of Medical Specialities.