Objective: To describe an epidemiological investigation of cluster of cases of MDR-Ab.
Methods: In July 2008 an index patient was transferred to our hospital with pneumonia & septicemia. An epidemiological investigation was conducted following a cluster of infections with MDR-Ab (similar strain as the index case) that occurred in 2 adjacent ICUs from Sept 2008. Investigation included review of microbiology reports and the infection control policies and procedures.
Results: MDR-Ab was isolated in 157 patients with clinical diagnosis as mentioned in Table below. They were isolated from lower respiratory tract infections, blood and surgical site infections (SSI). Invasive infections leading to mortality in 29 (18.47%). Active surveillance by culture showed contamination of the respiratory equipments. Revision of disinfection policy and compliance with infection control measures such as contact precautions & hand hygiene compliance were reinforced. These measures were met with limited success.
Table showing patient with HAIs.
No of patients
|Pneumonia + septicemia||17(10.82%)|
|Pneumonia + septicemia + SSI ||11(7%)|
|Septicemia + SSI ||8(5%)|
Conclusions: MDR-Ab is now well established nosocomial pathogen in critical care units. Vigilance active surveillance and on going assessment of infection control procedures such as care of respiratory equipments are important measures to contain the MDR Ab infection in resource limited settings.