- Email: [email protected]
Role of operating theatre environment in causing surgical site infections – One year longitudinal study
116
journal of patient safety & infection control 3 ( 2 0 1 5 ) 70–117
P123 Effectiveness of chlorhexidine-impregnated dressings in reducing CLABSI – A prospective study conducted at a level-1 trauma centre S. Nair, J. Gunjiyal, B. Thanbuana, N. John, P. Mathur, N. Rastogi Hospital Infection Control Unit, JPNA Trauma Centre, New Delhi, India Introduction: Central venous catheter (CVCs) are one of the most common devices used in critical care practices. It is also the source of highly morbid central line associated blood stream infections (CLABSIs). The aim of this study was to evaluate the effectiveness and safety of a chlorhexidinegluconate-impregnated dressing in the reduction of CVC colonization and CVC-associated BSIs at a level 1 trauma centre. Method: This is a prospective study for the period of 14 months (November 2013 to December 2014), for the patients who were admitted to the ICU and High Dependency Unit and the Wards of a tertiary care centre. CVCs were inserted in operation theatre pre-operatively and intra-operatively and in the ICUs post-operatively. Standardized checklists were formulated as per CDC guidelines for Central Line Insertion Procedure. These forms were filled up by the intensivist and later collected by Hospital Infection Control Nurses. Patients were followed up till the day of removal and analyzed. Of the 536 patients that were listed and included in the study, only 220 were followed up completely for seven consecutive days. In all the other patients, either the CVC was removed or the patient got discharged before the seven days of observation was over. The findings were compared with historical controls. Result: Chlorhexidine-gluconate-impregnated dressing was used for central line insertion of 536 patients. Of the 220 patients who had CVCs for at least seven days or more, 2.5% (4 patients) developed CLABSI. CVC were in 295 patients in the preceding year (historical control) of these, 15 developed CLABSI (5%). Conclusions: Chlorhexidine-impregnated dressing can provide considerable value in reducing the risk of CRBSI in patients with central vascular catheters. Conflicts of interest: The present study was not funded from any institutional/research funds. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.199
P124 Role of operating theatre environment in causing surgical site infections – One year longitudinal study D. Bhatia, S.U. Harakuni, V.M. Uppin, M.B. Nagamoti Jawaharlal Nehru Medical college, KLE University, Belagavi, India
Introduction: Surgical site infections (SSIs) contribute substantially to surgical morbidity and mortality each year. Since air can act as a reservoir for microorganisms, airborne microbial concentration in the operating theatre (OT) needs to be studied for its role in the causation of SSIs. Objective: The present study was done to investigate the correlation between the OT environment and SSIs. Methods: Elective clean and clean-contaminated surgeries only were included. Only first surgical case of a day was sampled. Pre- and post-operative air sampling was conducted by settle plate (1/1/1) method. Patients were followed up. Swabs from surgical incision site were taken and processed as per standard guidelines. Results: 29 clean and 67 clean-contaminated surgeries were included. Staphylococcus aureus was found in six pre-op OT plates (6.25%) and ten post-op OT plates (10.42%), colony count of more than nine. 50% of the isolates from the OT were susceptible to Erythromycin, 80% to Co-trimoxazole and 80% to Ciprofloxacin. None of the isolates were susceptible to Penicillin. Two patients pertaining to these OTs yielded Staphylococcus aureus from incision site on follow up. All the cases recovered uneventfully. Conclusion: The study found 6–10% of contamination of OT air. Patients did recover uneventfully as the patients received the drugs, post-operatively as per the antibiotic sensitivity report of the OT isolates. Thus surveillance of the OT environment is to be conducted vigilantly. The isolates thus obtained should be speciated and the antibiogram should be obtained to prevent post-operative infections. http://dx.doi.org/10.1016/j.jpsic.2015.10.200
P126 MDR MRSA prevalent resistance pattern: A scenario in a tertiary care hospital, North India S. Tyagi 1 , A. Oberoi 2 1
Christian Medical College & Hospital, Ludhiana, India 2 Department of Microbiology, Christian Medical College & Hospital, Ludhiana, India Introduction: Staphylococcus aureus (S. aureus) is an important nosocomial and community acquired pathogen which can cause both superficial and deep pyogenic infections as well as a number of toxin mediated illnesses. Increasing prevalence of MRSA (methicillin resistant Staphylococcus aureus) strains which not only show resistance to all -lactam agents, but also have a greater chance of being resistant to a variety of other non -lactam antibiotics has become a big problem today, which has left us with very few therapeutic alternatives available to treat Staphylococcal infections. Our aim of doing this study was to determine the prevalence of MRSA infection in our tertiary care hospital and their resistance pattern to different antibiotics so as to monitor the burden of this infection in our setup and revise our antibiotic policies as and when required. Methods: A prospective study was conducted in the Department of Microbiology of Christian Medical College
journal of patient safety & infection control 3 ( 2 0 1 5 ) 70–117
P123 Effectiveness of chlorhexidine-impregnated dressings in reducing CLABSI – A prospective study conducted at a level-1 trauma centre S. Nair, J. Gunjiyal, B. Thanbuana, N. John, P. Mathur, N. Rastogi Hospital Infection Control Unit, JPNA Trauma Centre, New Delhi, India Introduction: Central venous catheter (CVCs) are one of the most common devices used in critical care practices. It is also the source of highly morbid central line associated blood stream infections (CLABSIs). The aim of this study was to evaluate the effectiveness and safety of a chlorhexidinegluconate-impregnated dressing in the reduction of CVC colonization and CVC-associated BSIs at a level 1 trauma centre. Method: This is a prospective study for the period of 14 months (November 2013 to December 2014), for the patients who were admitted to the ICU and High Dependency Unit and the Wards of a tertiary care centre. CVCs were inserted in operation theatre pre-operatively and intra-operatively and in the ICUs post-operatively. Standardized checklists were formulated as per CDC guidelines for Central Line Insertion Procedure. These forms were filled up by the intensivist and later collected by Hospital Infection Control Nurses. Patients were followed up till the day of removal and analyzed. Of the 536 patients that were listed and included in the study, only 220 were followed up completely for seven consecutive days. In all the other patients, either the CVC was removed or the patient got discharged before the seven days of observation was over. The findings were compared with historical controls. Result: Chlorhexidine-gluconate-impregnated dressing was used for central line insertion of 536 patients. Of the 220 patients who had CVCs for at least seven days or more, 2.5% (4 patients) developed CLABSI. CVC were in 295 patients in the preceding year (historical control) of these, 15 developed CLABSI (5%). Conclusions: Chlorhexidine-impregnated dressing can provide considerable value in reducing the risk of CRBSI in patients with central vascular catheters. Conflicts of interest: The present study was not funded from any institutional/research funds. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.199
P124 Role of operating theatre environment in causing surgical site infections – One year longitudinal study D. Bhatia, S.U. Harakuni, V.M. Uppin, M.B. Nagamoti Jawaharlal Nehru Medical college, KLE University, Belagavi, India
Introduction: Surgical site infections (SSIs) contribute substantially to surgical morbidity and mortality each year. Since air can act as a reservoir for microorganisms, airborne microbial concentration in the operating theatre (OT) needs to be studied for its role in the causation of SSIs. Objective: The present study was done to investigate the correlation between the OT environment and SSIs. Methods: Elective clean and clean-contaminated surgeries only were included. Only first surgical case of a day was sampled. Pre- and post-operative air sampling was conducted by settle plate (1/1/1) method. Patients were followed up. Swabs from surgical incision site were taken and processed as per standard guidelines. Results: 29 clean and 67 clean-contaminated surgeries were included. Staphylococcus aureus was found in six pre-op OT plates (6.25%) and ten post-op OT plates (10.42%), colony count of more than nine. 50% of the isolates from the OT were susceptible to Erythromycin, 80% to Co-trimoxazole and 80% to Ciprofloxacin. None of the isolates were susceptible to Penicillin. Two patients pertaining to these OTs yielded Staphylococcus aureus from incision site on follow up. All the cases recovered uneventfully. Conclusion: The study found 6–10% of contamination of OT air. Patients did recover uneventfully as the patients received the drugs, post-operatively as per the antibiotic sensitivity report of the OT isolates. Thus surveillance of the OT environment is to be conducted vigilantly. The isolates thus obtained should be speciated and the antibiogram should be obtained to prevent post-operative infections. http://dx.doi.org/10.1016/j.jpsic.2015.10.200
P126 MDR MRSA prevalent resistance pattern: A scenario in a tertiary care hospital, North India S. Tyagi 1 , A. Oberoi 2 1
Christian Medical College & Hospital, Ludhiana, India 2 Department of Microbiology, Christian Medical College & Hospital, Ludhiana, India Introduction: Staphylococcus aureus (S. aureus) is an important nosocomial and community acquired pathogen which can cause both superficial and deep pyogenic infections as well as a number of toxin mediated illnesses. Increasing prevalence of MRSA (methicillin resistant Staphylococcus aureus) strains which not only show resistance to all -lactam agents, but also have a greater chance of being resistant to a variety of other non -lactam antibiotics has become a big problem today, which has left us with very few therapeutic alternatives available to treat Staphylococcal infections. Our aim of doing this study was to determine the prevalence of MRSA infection in our tertiary care hospital and their resistance pattern to different antibiotics so as to monitor the burden of this infection in our setup and revise our antibiotic policies as and when required. Methods: A prospective study was conducted in the Department of Microbiology of Christian Medical College