Epidemiology of Multidrug Resistant Infections after Inter-ICU Transfer in India
Anirban H Choudhuri1, Bhuvna Ahuja1, Partha S Biswas2
1Department of Anesthesiology and Intensive Care, Jawaharlal Institute of Postgraduate Medical Education and Research, New Delhi, India.
Background And Aims:
The patients in the intensive care unit (ICU) are often infected with multidrug resistant (MDR) organisms. When they are transferred to other ICUs, they can expand the reservoir of MDR organisms and pose a threat to the infection control program. The present observational study was undertaken to describe the epidemiology and compare the outcome of MDR and non-MDR infections after inter ICU patient transfer.
Materials And Methods:
A retrospective study was conducted in a cohort of 134 consecutive admitted patients in a tertiary care ICU from other ICUs. The primary objective was to measure the prevalence of MDR and non-MDR infections. The secondary objective was to compare the outcome between MDR and non-MDR group and identify the factors independently associated with mortality for each group.
Results:
Among 134 patients, 89 had infections (66.4%) and in 29 (21.6%) were due to MDR organisms. The most common organism was Klebsiella in the MDR and E. coli in the non-MDR group. There was no difference between the groups in mortality, duration of mechanical ventilation and length of ICU stay. The duration of mechanical ventilation and ICU stay >7 days was independently associated with mortality in the MDR group. No association was found in the non-MDR group.
Conclusion:
The study demonstrates a high prevalence of MDR infections after inter ICU transfer. There is no difference in outcome between the groups, but the mortality in the MDR group is independently associated with a longer duration of mechanical ventilation and ICU stay.
How To Cite This Article:
Choudhuri AH, Ahuja B, Biswas PS, Uppal R. Epidemiology of Multidrug Resistant Infections after Inter-ICU Transfer in India. Indian Journal of Critical Care Medicine, January 2019;23(1):1-6.
Insights
Multidrug-resistant (MDR) infections are common in intensive care units (ICUs) after patient transfers. While outcomes were similar, longer ventilation and ICU stays independently predicted mortality in the MDR group.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Patients in intensive care units (ICUs) frequently acquire multidrug-resistant (MDR) organisms.
- Inter-ICU patient transfers can facilitate the spread of MDR organisms, posing infection control challenges.
Purpose of the Study:
- To describe the epidemiology of infections following inter-ICU patient transfer.
- To compare outcomes between multidrug-resistant (MDR) and non-MDR infections.
- To identify factors associated with mortality in MDR and non-MDR infection groups.
Main Methods:
- Retrospective study of 134 consecutive patients transferred between ICUs.
- Assessed the prevalence of MDR and non-MDR infections.
- Compared patient outcomes and analyzed mortality predictors.
Main Results:
- 66.4% of patients developed infections, with 21.6% caused by MDR organisms.
- No significant difference in mortality, mechanical ventilation duration, or ICU stay between MDR and non-MDR groups.
- Longer mechanical ventilation and ICU stay (>7 days) were independently associated with mortality in the MDR group.
Conclusions:
- A high prevalence of MDR infections exists post-inter-ICU transfer.
- Patient outcomes do not differ significantly between MDR and non-MDR infections.
- Prolonged mechanical ventilation and ICU stay are key mortality predictors for MDR infections.
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