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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Health-care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study
The Lancet Global Health, Volume 10, No. 9, Year 2022
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Description
Background: Health-care-associated infections (HAIs) cause significant morbidity and mortality globally, including in low-income and middle-income countries (LMICs). Networks of hospitals implementing standardised HAI surveillance can provide valuable data on HAI burden, and identify and monitor HAI prevention gaps. Hospitals in many LMICs use HAI case definitions developed for higher-resourced settings, which require human resources and laboratory and imaging tests that are often not available. Methods: A network of 26 tertiary-level hospitals in India was created to implement HAI surveillance and prevention activities. Existing HAI case definitions were modified to facilitate standardised, resource-appropriate surveillance across hospitals. Hospitals identified health-care-associated bloodstream infections and urinary tract infections (UTIs) and reported clinical and microbiological data to the network for analysis. Findings: 26 network hospitals reported 2622 health-care-associated bloodstream infections and 737 health-care-associated UTIs from 89 intensive care units (ICUs) between May 1, 2017, and Oct 31, 2018. Central line-associated bloodstream infection rates were highest in neonatal ICUs (>20 per 1000 central line days). Catheter-associated UTI rates were highest in paediatric medical ICUs (4·5 per 1000 urinary catheter days). Klebsiella spp (24·8%) were the most frequent organism in bloodstream infections and Candida spp (29·4%) in UTIs. Carbapenem resistance was common in Gram-negative infections, occurring in 72% of bloodstream infections and 76% of UTIs caused by Klebsiella spp, 77% of bloodstream infections and 76% of UTIs caused by Acinetobacter spp, and 64% of bloodstream infections and 72% of UTIs caused by Pseudomonas spp. Interpretation: The first standardised HAI surveillance network in India has succeeded in implementing locally adapted and context-appropriate protocols consistently across hospitals and has been able to identify a large number of HAIs. Network data show high HAI and antimicrobial resistance rates in tertiary hospitals, showing the importance of implementing multimodal HAI prevention and antimicrobial resistance containment strategies. Funding: US Centers for Disease Control and Prevention cooperative agreement with All India Institute of Medical Sciences, New Delhi. Translation: For the Hindi translation of the abstract see Supplementary Materials section. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
Authors & Co-Authors
Malpiedi, Paul J.
United States, Atlanta
Centers for Disease Control and Prevention
Walia, Kamini
India, New Delhi
Indian Council of Medical Research
Srikantiah, Padmini
United States, Atlanta
Centers for Disease Control and Prevention
Gupta, Sunil Kumar
India, New Delhi
Ministry of Health and Family Welfare
Chakrabarti, Arunaloke K.
India, Chandigarh
Postgraduate Institute of Medical Education & Research, Chandigarh
Ray, Pallab
India, Chandigarh
Postgraduate Institute of Medical Education & Research, Chandigarh
Taneja, Neelam S.
India, Chandigarh
Postgraduate Institute of Medical Education & Research, Chandigarh
Rupali, Priscilla
India, Vellore
Christian Medical College, Vellore
Balaji, Veeraraghavan
India, Vellore
Christian Medical College, Vellore
Rodrigues, Camilla S.
India, Mumbai
P.d. Hinduja National Hospital and Medical Research Centre
Wattal, Chand
India, New Delhi
Sir Ganga Ram Hospital
Bhattacharya, Sanjay
India, Kolkata
Tata Medical Center
Behera, Bijayini K.
India, Bhubaneswar
All India Institute of Medical Sciences, Bhubaneswar
Singh, Sanjeev K.
India, Kochi
Amrita Institute of Medical Sciences India
Fomda, Bashir Ahmad
India, Srinagar
Sher-i-kashmir Institute of Medical Sciences
Gaind, Rajni
Unknown Affiliation
Gupta, Neil
United States, Atlanta
Centers for Disease Control and Prevention
Sharma, Aditya
United States, Atlanta
Centers for Disease Control and Prevention
VanderEnde, Daniel S.
United States, Atlanta
Centers for Disease Control and Prevention
Laserson, Kayla F.
United States, Atlanta
Centers for Disease Control and Prevention
Kumar, Subodh Senthil
Unknown Affiliation
Soni, Kapil Dev
Unknown Affiliation
Garg, Pramod Kumar
Unknown Affiliation
Kapil, Arti
Unknown Affiliation
Lodha, Rakesh K.
Unknown Affiliation
Gupta, Neeraj
Unknown Affiliation
Verma, Sheetal
Unknown Affiliation
Kalwaje Eshwara, Vandana
Unknown Affiliation
Chandy, Mammen
Unknown Affiliation
Goel, Gaurav
Unknown Affiliation
Sharma, Rajeev M.
Unknown Affiliation
Statistics
Citations: 13
Authors: 31
Affiliations: 25
Identifiers
Doi:
10.1016/S2214-109X(22)00274-1
ISSN:
2214109X
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study