Pune: Instances of infectious diseases in India are among the highest in the world. It has been found that patients visiting hospitals often arrive with serious infections in Intensive Care Units (ICU) or general wards. Many hospitals and nursing homes often do not follow infection control practices. This leads to the spread of diseases.
A large amount of antibiotics is consumed to fight infections, some of them save lives, but every use adds to resistance in bacteria.
A hospital-acquired infection (HAI), also known as a nosocomial infection, is commonly found in Intensive Care Unit (ICU) patients. It is associated with morbidity and mortality. This occurs based on the severity of the illness and due to the use of mechanical ventilation or similar means, which interrupt the normal defence mechanism within the body. Malnourished or bed-ridden patients are more susceptible to multi-drug resistant organism (MDRO).
There are numerous planning, developments and execution of rules made for infection preventive strategies. Most ICUs focus on monitoring hand hygiene, update on isolation precaution, avoiding device-related infection and MDRO. Their main focus remains the clinical end points such as controlling high infection rate, maintaining low infection rate and preventing antibiotics resistance.
Pune-based Dr Maheshkumar Lakhe, Infectious Diseases Specialist, said, “There are various sources of infections that can be transmitted from other patients, healthcare workers or visitors.”
“Inanimate objects like the patient’s bed surface, equipment or other devices or objects used in the ICU, if contaminated can lead to infections. Endogenous flora from the skin, mucus membrane, GI tract or respiratory tract can cause a spread of infections. Intrinsic risk factors include immuno-compromised state, severity of illness, extremes of age, inadequate nutrition and immobilisation make ICU patient more susceptible. Extrinsic risk factors include invasive procedure, catheters, mechanical ventilation and other therapeutic interventions in ICU,” said Lakhe.
“There are other modes of transmission; airborne transmission, droplet transmission or usage of common vehicles like ventilator. Ventilator associated pneumonia (VAP) is the most common infection acquired in the ICU. VAP is a pneumonia, which occurs in a patient, who was intubated and mechanically ventilated at the time of onset of pneumonia or within 48 hours before onset of pneumonia. It is advisable to ensure hand hygiene before having direct contact with patients,” he added.
Another commonly found infection that accounts for 38 per cent of all infections in the hospital is Catheter Associated Urinary Tract Infection (CAUTI). Organisms attacking any portion of the urinary system can cause urinary tract infections in the kidneys, bladder, prostate, urethra and urine. If bacteria infects a particular site, other areas are also at risk. Infections or bacteria may arise due to short-term catheter associated bacteria. However, these are without any symptoms.
