Microbiological profile of healthcare-associated infections at a tertiary care center, New Delhi, India

Objective: To determine the incidence and microbiological profile of healthcare-associated infections (HAIs) in a Medical Intensive Care Unit (MICU) in New Delhi, India. Methods: All patients aged 18 years and above who were admitted to the MICU and suspected of having HAIs by the treating physicians were enrolled in this study. Different samples (pus, blood, urine, and sterile fluid/aspirates) were collected from all patients according to standard protocol. Cultures and microscopy were performed on the samples, and identification of growth was done using biochemical tests and the VITEK-2 system. The antimicrobial susceptibility testing was also conducted according to Clinical and Laboratory Standard Institute guidelines. Results: Among 81 patients with central lines, urinary catheters, and mechanical ventilation, HAIs were observed in 12 (14.8%) patients. Of these 81 patients, ventilator-associated pneumonia (VAP) occurred in 9 patients (11.1%) and central line-associated bloodstream infection was observed in 3 patients (3.7%). The microorganisms isolated from patients with VAP included Klebsiella pneumoniae in 6 cases, Acinetobacter lwoffii in 1 case, Escherichia coli in 1 case and methicillin-resistant Staphylococcus aureus in 1 case. Among the Gram-negative isolates from VAP patients, high resistance was observed in Escherichia coli (83.33%) and Klebsiella pneumoniae (100%) to both imipenem and meropenem. All the isolates were susceptible to colistin. Conclusions: The study highlights the high incidence of HAIs in critically ill MICU patients and the alarming prevalence of carbapenem resistance in the HAI-causing pathogens. HAIs are largely preventable through effective infection prevention and control measures.