Epidemiology of multidrug resistant infections after inter ICU transfer in India

Abstract

Background and aims: The patients in the intensive care unit (ICU) are often infected with multi-drug resistant (MDR) organisms. When they are transferred to other ICUs, they can expand the reservoir of MDR organisms and pose a threat to the infection control programme. The present observational study was undertaken to describe the epidemiology and compare the outcome of MDR and non-MDR infections after inter ICU patient transfer. Subjects and methods: A retrospective study was conducted in a cohort of 134 consecutive admitted patients in a tertiary care ICU from other ICUs. The primary objective was to measure the prevalence of MDR and non-MDR infections. The secondary objective was to compare the outcome between MDR and non-MDR group and identify the factors independently associated with mortality for each group. Results: Among 134 patients, 89 had infections (66.4%) and in 29 (21.6%) were due to MDR organisms. The commonest organism was Klebsiella in the MDR and E. coli in the non-MDR group. There was no difference between the groups in mortality, duration of mechanical ventilation and length of ICU stay. The duration of mechanical ventilation and ICU stay > 7 days was independently associated with mortality in the MDR group. No association was found in the non-MDR group. Conclusion: The study demonstrates a high prevalence of MDR infections after inter ICU transfer. There is no difference in outcome between the groups, but the mortality in the MDR group is independently associated with a longer duration of mechanical ventilation and ICU stay.