A STUDY ON SECONDARY BLOODSTREAM INFECTIONS IN TERTIARY CARE SETTINGS: AN UNATTENDED ISSUE

Background: The Blood Stream infection (BSI) is one of the most common causes of morbidity in the intensive care units. While many studies focus on the BSI and factors associated; a specic, widely accepted benchmark for secondary bloodstream infection (BSI) rates in India is not readily available making it an unattended issue. Studies are needed to demonstrate the prevalence of secondary BSIs in various settings, including ICUs, and highlight the importance of primary sources and organism wise distribution. This research article addresses the prevalence of various sources of Secondary BSI in a tertiary care setting. Methods: This study was initiated with an aim to analyze the primary and secondary BSI for a period of one year. All primary sources of secondary BSI cases were determined by studying the Blood culture results in microbiology department from January 2023 to December 2023. During the analysis secondary BSI were determined by NHSN denitions for Secondary BSI events. Primary specimen sources were determined for all secondary BSIs. Organisms isolated from positive cultures were also studied. Results: All patients from the tertiary care hospital were included in the study for the time period of Jan 2023-December 2023. Blood culture specimens were received from 5857 unique patients with 31% culture positive, amongst which 5.13% (94 cases) were Secondary BSI. The main primary sources of infections causing secondary BSI are wounds and drain uids 37%, respiratory tract 26%, urinary tract 19%, central line catheter 7%, CSF 9%, gastrointestinal tract 2%. The organisms isolated from the secondary BSI cases were Klebsiella pneumoniae 26%, Acinetobacter baumannii 23%, Staphylococcus aureus 14%, Pseudomonas aeruginosa 19%, Escherichia coli 9%, Enterococcus spp. 7%, Proteus mirabilis 2%. Conclusions: Prompt identication of source of secondary BSI is signicant for targeting the patient treatment.