‘Devices cause most hospital-acquired infections’

Medical devices such as central lines, mechanical ventilators and urinary catheters are responsible for three very common hospital-acquired infections, said Victor D. Rosenthal, a specialist in infectious diseases and founder and chairman of the International Nosocomial Infection Control Consortium.

Dr. Rosenthal, who was in the city for a conference, said these devices caused all blood stream infections, 90 per cent of pneumonia and 90 per cent of urinary tract infections in hospitals.

“Devices are responsible for about 95 per cent of all hospital-acquired infections, and lead to a three-times increase in length of stay, costs and mortality. But following a simple set of 12 guidelines could help reduce these infections considerably,” he said.

An Indian Intensive Care Case Mix and Practice Patterns study published in 2012 with a sample size of 4,209 patients admitted to 124 ICUs across 17 States, found that 26 per cent of the patients in ICUs contracted sepsis.

Mortality in patients with sepsis was 42.2% as opposed to 17.8% in those who did not get it, preliminary findings of the study said, according to a media report.

Dr. Rosenthal, who said he had been working with Indian doctors and nurses both in the government and private sector since 2003, said in Indian patients, the rate of blood stream infections was five times higher than that of patients in the United States.

One of the primary causes of hospital-acquired infections in India, he explained, was the use of older, less expensive technology. “New technology, including collapsible IV containers, split septum connectors, single-use flushing devices — is more expensive but cost-effective in the long run as it helps prevent infections,” he said. The other problem is that there is not much awareness of guidelines to curb hospital-acquired infections.

No national guidelines

“There are no national guidelines on infection control. Most of that are used by hospitals are extrapolated from the West, and may not be suitable for India. However, the National Accreditation Board for Hospitals and Healthcare Providers has now initiated compulsory reporting of data on infections,” said Santosh Kumar, senior quality advisor, UP Health Systems Strengthening Project, a World Bank initiative.