Dr Hitender Gautam1, Dr. Rahul Ranjan2, Ms A Agnes3, Ms Priyanka3, Ms Poonam3, Ms Sapna3, Dr. Bimal Kumar Das1
1Department of Microbiology, All India Institute of Medical Sciences, AIIMS, New Delhi, India, India, 2Hospital Administration, Dr. BRAIRCH, AIIMS, New Delhi, India, India, 3Infection Control Nurse, Dr. BRAIRCH (Cancer Centre), AIIMS, New Delhi, India
Biography:
I am working as Professor in Department of Microbiology, All India Institute of Medical Sciences, AIIMS, New Delhi, a premiere public sector medical school of India. I am looking after Infection Prevention & Control at Cancer centre Dr. BRAIRCH of AIIMS, New Delhi
Abstract:
Introduction
Central Venous Catheters considered source of Central line-associated bloodstream infections (CLABSI). Malignancy carries Odds-Ratio of 1.35 for HAIs. As per western literature, Gram positive cocci (GPC) infections, are frequently associated with these IV devices. In Indian cancer settings, Gram negative bacteria (GNBs) were found to be more common cause of infections.
Methods
Prospective CLABSI surveillance study (CDC/NHSN) from tertiary-care cancer-centre, Dr. BRAIRCH, AIIMS-New Delhi, India. CLABSI etiology data from 2020 to 2023 was included for this study.
Results
We calculated data for 16,540, 29062, 35624, 37426 patient-days in year 2020, 2021, 2022, 2023 and 3658, 5687, 6758, 7478 central-line days in year 2020, 2021, 2022, 2023 respectively. In year 2020, 54% CLABSI etiology was due to GNBs with predominant being Klebsiella pneumoniae (25.4%), while among GPCs, 38% were due to Staphylococcus spp. In year 2021, 58% CLABSI etiology was due to GNBs with predominant being Klebsiella pneumoniae (35%), while among GPCs, 34% were due to Staphylococcus spp. In year, 2022, 45% CLABSI etiology was due to GNBs with predominant being Escherichia coli (19%), while among GPCs, 9% were due to Enterococcus spp. In year, 2023, 80% CLABSI etiology was due to GNBs with increase of Acinetobacter spp. (19%) while among GPCs, 10% were due to Enterococcus spp.
Conclusion
Etiology of central line blood stream infection’s throughout the world is evolving around highly drug resistant Klebsiella spp, Acinetobacter spp, Staphylococcus spp & Enterococcus spp. This is a cause of concern and requires strict infection control practices for control of these infections.