Hospital acquired infections: preventable cause of mortality in spinal cord injury patients.
BACKGROUND
There is an alarming rate of morbidity and mortality observed in the trauma victims who suffer spinal cord injuries (SCI). Such patients are admitted immediately and stay for longer periods of time and thus are at risk of acquiring nosocomial infections.


OBJECTIVE
The aim of this study is to analyze the primary cause of mortality in SCI patients.


METHODS
Retrospective study.


METHODS
We conducted a retrospective 4 year analysis of the postmortem data of 341 patients who died after sustaining SCI at a tertiary care apex trauma center of India. Epidemiological data of patients including the type of trauma, duration of hospital stay, cause of death and microbiological data were recorded.


RESULTS
On autopsy, out of 341 patients, the main cause of death in the SCI patients was ascertained to be infection/septicemia in 180 (52.7%) patients, the rest 161 (47.2%) died due to severe primary injury. Respiratory tract infections (36.4%) were predominant followed by urinary tract infections (32.2%), blood stream infections (22.2%), wound infections (7.1%) and meningitis reported in only 5 (2.1%) cases. Acinetobacter sp (40%) was the predominant organism isolated, followed by Pseudomonas sp (16.3%), Klebsiella sp (15.1%), Candida sp (7.8%), Escherichia coli (6.9%), Staphylococcus aureus (6.9%), Proteus sp (3.3%), Enterobacter sp and Burkholderia sp (two cases each) and Stenotrophomonas sp (one case). A high level of multidrug resistance was observed.


CONCLUSIONS
Hospital acquired infections (HAI) are leading cause of loss of young lives in trauma patients; hence efforts should be made to prevent HAIs.
Department of Forensic, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Sanjeev
S
Lalwani
Department of Laboratory Medicine, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Parul
P
Punia
Department of Laboratory Medicine, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Purva
P
Mathur
Department of Orthopedics, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Vivek
V
Trikha
Department of Orthopedics, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Gurudutta
G
Satyarthee
Department of Surgery, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Mahesh C
MC
Misra
Hospital acquired infections; level of injury; multidrug resistance; respiratory tract infections; spinal cord injury; urinary tract infections