title: Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit.
abstract: BACKGROUND
  Nosocomial infections (NIs) in the postoperative period not only increase morbidity and mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective study was undertaken to (a) evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b) identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac Surgical Intensive Care Unit (CSICU).
  
  
  METHODS
  After ethics committee approval, the CSICU records of all patients who underwent cardiovascular surgery between January 2013 and December 2014 were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and their antibiotic resistance, length of CSICU stay, and patient-outcome were determined.
  
  
  RESULTS
  Three hundred and nineteen of 6864 patients (4.6%) developed NI after cardiac surgery. Lower respiratory tract infections (LRTIs) accounted for most of the infections (44.2%) followed by surgical-site infection (SSI, 11.6%), bloodstream infection (BSI, 7.5%), urinary tract infection (UTI, 6.9%) and infections from combined sources (29.8%). Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram-negative bacteria isolated from different sources were found to be highly resistant to commonly used antibiotics.
  
  
  CONCLUSIONS
  The incidence of NI and sepsis-related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory tract was the most common site of infection and Gram-negative bacilli, the most common pathogens after cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Manoj Kumar
authors.initials: MK
authors.lastname: Sahu
authors.forename: Bharat
authors.initials: B
authors.lastname: Siddharth
authors.forename: Arin
authors.initials: A
authors.lastname: Choudhury
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Vishnubhatla
authors.forename: Sarvesh Pal
authors.initials: SP
authors.lastname: Singh
authors.forename: Ramesh
authors.initials: R
authors.lastname: Menon
authors.forename: Poonam Malhotra
authors.initials: PM
authors.lastname: Kapoor
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.forename: Shiv
authors.initials: S
authors.lastname: Choudhary
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents