‘Proper guidelines can help reduce HAI rate’

In India, studies say that HAI rates are five times the number recorded in the US. A study conducted by Dr Victor Rosenthal, Chairman, International Nosocomial Infection Control Consortium (INICC), in India, between April 2012 and August 2014 on 1,096 patients has revealed that the usage of outdated technology contributed to CLABSIs (catheter associated blood stream infections). 

Adoption of advanced technology namely, split septum needleless connectors and single use prefilled flush could help in cost saving to the tune of $402.88 and an increase in quality-adjusted life years of 0.0008 per patient, says Dr Rosenthal. 

Dr Rosenthal has been working with Indian hospitals for more than a decade now to track the data of infections in hospitals. INICC has been helping hospitals with tools and methods to measure and prevent HAIs. 

In the absence of national guidelines for prevention of hospital acquire infections (HAI), Dr Rosenthal says that guidelines followed in the West wouldn’t be suitable for hospitals in developing countries like India. 

Some hospitals in India following the CDC (Centre for Disease Control and Prevention) guidelines, there are several unaddressed factors that contribute to these infections. Dr M N Sivakumar, who collaborated with Dr Rosenthal in both studies, adds that formulating guidelines in the absence of data makes the process difficult. “There is a need for national guidelines.

We don’t have benchmarks or guidelines. Most of us follow CDC based in the US. These are different kinds of patient population. What suits for developed countries doesn’t suit us. The critical care society is coming up with guidelines,” he says. He adds that till the accreditation process came up, hospitals here were not even measuring HAIs. 

Dr Rosenthal reveals that India is one of the countries with the lowest HAI rates, though it is five times the US rate. The Central line-associated bloodstream infections (CLAB) is around 5 CLAB per 1000 CL days, whereas in the US the CLAB rate is 1CLAB per 1000 CL days. “In other developing countries, it is 10 or even 15 times,” he says. 

An earlier study, Indian Intensive Care Case Mix and Practice Patterns, carried out by Dr Victor Rosenthal and published in 2012 with a sample size of 4,209 patients admitted in 124 ICUs across 17 states found that one out of every eight patients in India die from infections contracted in ICUs. INDICAPS found that 26 per cent of the patients in ICUs contracted sepsis with 42.2 per cent of them dying of it. The other common infections were pneumonia and urinary tract infections.