(1273) Prospective Surveillance Study of CLABSI and VAP in ICU of Tertiary Academic Hospital in North India

Sunday, February 23, 2025

11:00am – 12:00pm Eastern Time

Location: Connections Central - RST 13

First Author(s)

NS

Neeru Sahni, MD, MAMS (she/her/hers)

Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, IND

Co-Author(s)

MB

Manisha Biswal, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
LY

Laxminarayana Yaddanapudi, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
PR

Pallab Ray, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
Nt

Neelam taneja, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
SM

Shivaprakash MR, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
VS

Vikas Saini, MD

Professor
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India
PM

Purva Mathur, MD

Professor
All India Institute of Medical Sciences, New Delhi
New delhi, Delhi, India
KW

Kamini Walia, PhD, MPH

Scientist G
Indian Council of Medical Research
New delhi, Delhi, India

Introduction: A network approach to HAI surveillance was started in 2016 by collaboration between Indian Council of Medical Research (ICMR) with All India Institute of Medical Sciences, New Delhi, India. This work was supported by a US CDC cooperative agreement to advance the Global Health Security Agenda in India (cooperative agreement number 1U2GGH001869). We present data of CLABSI and VAP surveillance from December 2022 to May 2024, from our ICU in PGIMER, Chandigarh, India.

Methods: The surveillance teams were trained by network coordination team to apply standardized definition and surveillance methodology. After approval from Institute Ethics committee (IEC-12/2021-2251), trained teams prospectively collected data on number of patient and central line (CL) days, sites of CL, episodes of BSI, CLABSI per 1000CL days and microorganisms causing CLABSI. Additionally, monthly CLABSI rate of our ICU were compared with INICC and CDC-NHSN benchmark. The same team did prospective VAP surveillance according to modified CDC criteria and collected following data: total number of patient days and ventilator days, episodes of VAP, microorganisms causing VAP, mean VAP per 1000 ventilator days and mortality in patients with VAP. The monthly VAP rates were compared with INICC benchmark.

Results: Total number of patient days were 6315 with 4049 CL days. Among 86 episodes of BSI, there were 36 CLABSI, 17 primary BSI and 33 secondary BSIs. The mean CLABSI per 1000 CL days was 8.89 and the total mortality in patients with BSI was 52.3%. The monthly CLABSI rate per 1000 CL days was below the CLABSI rate of India, although it was above INICC(4.82) and CDC-NHSN(1.25) benchmark. The episodes of CLABSI were higher in patients with more than 16 days of CL.
In VAP surveillance, total number of patient days were 6058 with 3786 ventilator days. Total number of episodes of VAP were 41, mean VAP per 1000 ventilator days was 10.83. The total mortality in patients with VAP was 51.1%. The VAP rates of our ICU reached below that reported for India by INICC(14.30). The most common organism causing both CLABSI and VAP was Acinetobacter baumannii.

Conclusions: A network approach to HAI surveillance helped achieve a continuous surveillance of CLABSI and VAP in our ICU making it possible to compare trends of HAIs with benchmarks.