A Prospective Study to Evaluate the Prevalence of Infection in the Environment of ICU of a Tertiary Care Government Hospital

Abstract

Introduction: The presence of microorganisms with acquired resistance to multiple antibiotics complicates the management and outcome of critically ill patients. In the intensive care units (ICUs), this can lead to increased mortality. A remarkable increase in microbial resistance aiming selected pathogens has been reported over time. Exposure to antimicrobial agents has been thought to be an important contributor to its development. The environment that can contribute to this spread of infection can be of any kind, e.g., equipment, water, mobile phones, sink, taps, etc. Planning for containment and control of hospitalacquired infection (HAI) has to be based on the knowledge of possible sources. Thus we planned this study
in the hospital.

Methods: A prospective study was conducted, in which surveillance of the ICU environment and personnel, was carried out. Swabs were collected from 13 different sites from the environment (sinks, respirators, medicine trolleys, bed sheets, etc.) and healthcare workers twice a week throughout the duration of the study. The swabs were inoculated into a transport media and processed in the department of microbiology. Data was collected as per reporting received from the microbiology department. Compiled data was presented as actual number and percentage.

Result: Two hundred thirteen (63%) of 338 samples collected no growth. All the site samples were infected except the disinfectant solutions and the doctors. Escherichia Coli was the commonest organism grown (74.4%), 12% grew Klebsiella, 4.8% showed Pseudomonas, 4.8% coagulase negative staph, 4% showed Staph aureus. All 52 water samples were positive for E. coli. The prevalence of microorganisms was maximum in the water (100%) and quite high in the sinks.

Conclusion: The ICU environment seems to be a potential reservoir for pathogens. Therefore, strict adherence to environmental infection control measures is essential to prevent healthcare-associated infections.