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Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics
OBJECTIVES: To compare the predicted vs observed mortality rate, criticality, and length of stay of the patients with healthcare-associated infections (HAIs) in intensive care units (ICUs) of a tertiary health center through acute physiology and chronic health evaluation (APACHE) IV scoring. To anal...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Jaypee Brothers Medical Publishers
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297239/ https://www.ncbi.nlm.nih.gov/pubmed/32565635 http://dx.doi.org/10.5005/jp-journals-10071-23384 |
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author | Gunasekaran, Santosh Mahadevaiah, Sumana |
author_facet | Gunasekaran, Santosh Mahadevaiah, Sumana |
author_sort | Gunasekaran, Santosh |
collection | PubMed |
description | OBJECTIVES: To compare the predicted vs observed mortality rate, criticality, and length of stay of the patients with healthcare-associated infections (HAIs) in intensive care units (ICUs) of a tertiary health center through acute physiology and chronic health evaluation (APACHE) IV scoring. To analyze the drug sensitivity pattern of the isolated pathogen. DESIGN: This is a prospective observational study involving the patients admitted to various ICUs of a tertiary care teaching hospital. Among 1,229 patients who were admitted in the ICUs for a period of 2.5 months (74 days), 767 patients stayed beyond 48 hours. They were monitored and 87 of them who developed HAIs were included in the study. The organisms isolated from the infection site were identified, and the drug resistance pattern was reported as per standard guidelines. The patients were followed up till their discharge, and adequate details pertaining to the study were collected including demographic details and physiological and biochemical parameters to calculate APACHE IV score, length of stay, and prognosis. SETTING: Intensive care units of JSS Hospital, Mysuru, Karnataka, India. SUBJECTS/PATIENTS: All patients who developed HAI in ICUs. INTERVENTIONS: Nil. MEASUREMENTS AND MAIN RESULTS: The HAI rate observed in this study was 15.7%. Ventilator-associated pneumonia (VAP) was the most common type of infection. Klebsiella and Acinetobacter were the frequently isolated organisms. There was a high prevalence of drug resistance among these pathogens. The ICU mortality in infected patients was 21.83%, roughly twice as that of uninfected patients. The observed length of stay was 11.66 (±8.53) days. CONCLUSION: Healthcare-associated infection was associated with long duration of ICU stay. There was a high prevalence of drug resistance to various antibiotics. Acute physiology and chronic health evaluation IV score was not found to be good scoring system to predict the mortality and length of stay in the patients who had HAI. HOW TO CITE THIS ARTICLE: Gunasekaran S, Mahadevaiah S. Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics. Indian J Crit Care Med 2020;24(4):252–257. |
format | Online Article Text |
id | pubmed-7297239 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-72972392020-06-20 Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics Gunasekaran, Santosh Mahadevaiah, Sumana Indian J Crit Care Med Original Article OBJECTIVES: To compare the predicted vs observed mortality rate, criticality, and length of stay of the patients with healthcare-associated infections (HAIs) in intensive care units (ICUs) of a tertiary health center through acute physiology and chronic health evaluation (APACHE) IV scoring. To analyze the drug sensitivity pattern of the isolated pathogen. DESIGN: This is a prospective observational study involving the patients admitted to various ICUs of a tertiary care teaching hospital. Among 1,229 patients who were admitted in the ICUs for a period of 2.5 months (74 days), 767 patients stayed beyond 48 hours. They were monitored and 87 of them who developed HAIs were included in the study. The organisms isolated from the infection site were identified, and the drug resistance pattern was reported as per standard guidelines. The patients were followed up till their discharge, and adequate details pertaining to the study were collected including demographic details and physiological and biochemical parameters to calculate APACHE IV score, length of stay, and prognosis. SETTING: Intensive care units of JSS Hospital, Mysuru, Karnataka, India. SUBJECTS/PATIENTS: All patients who developed HAI in ICUs. INTERVENTIONS: Nil. MEASUREMENTS AND MAIN RESULTS: The HAI rate observed in this study was 15.7%. Ventilator-associated pneumonia (VAP) was the most common type of infection. Klebsiella and Acinetobacter were the frequently isolated organisms. There was a high prevalence of drug resistance among these pathogens. The ICU mortality in infected patients was 21.83%, roughly twice as that of uninfected patients. The observed length of stay was 11.66 (±8.53) days. CONCLUSION: Healthcare-associated infection was associated with long duration of ICU stay. There was a high prevalence of drug resistance to various antibiotics. Acute physiology and chronic health evaluation IV score was not found to be good scoring system to predict the mortality and length of stay in the patients who had HAI. HOW TO CITE THIS ARTICLE: Gunasekaran S, Mahadevaiah S. Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics. Indian J Crit Care Med 2020;24(4):252–257. Jaypee Brothers Medical Publishers 2020-04 /pmc/articles/PMC7297239/ /pubmed/32565635 http://dx.doi.org/10.5005/jp-journals-10071-23384 Text en Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd. © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Article Gunasekaran, Santosh Mahadevaiah, Sumana Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title | Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title_full | Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title_fullStr | Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title_full_unstemmed | Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title_short | Healthcare-associated Infection in Intensive Care Units: Overall Analysis of Patient Criticality by Acute Physiology and Chronic Health Evaluation IV Scoring and Pathogenic Characteristics |
title_sort | healthcare-associated infection in intensive care units: overall analysis of patient criticality by acute physiology and chronic health evaluation iv scoring and pathogenic characteristics |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297239/ https://www.ncbi.nlm.nih.gov/pubmed/32565635 http://dx.doi.org/10.5005/jp-journals-10071-23384 |
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