Hospital Acquired Infections: Preventable Cause of Mortality in Spinal Cord Injury Patients

• Published in: Journal of laboratory physicians Vol. 6; no. 1; pp. 036 - 039
• Main Authors: Lalwani, Sanjeev, Punia, Parul, Mathur, Purva, Trikha, Vivek, Satyarthee, Gurudutta, Misra, Mahesh C
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01.01.2014; Medknow Publications; Medknow Publications and Media Pvt. Ltd; Thieme Medical Publishers Inc; Medknow Publications & Media Pvt Ltd; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: Care and treatment; Causes of; Complications and side effects; Cross infection; Health aspects; hospital acquired infections; level of injury; Mortality; multidrug resistance; Nosocomial infections; Original; Original Article; Patient outcomes; Prevention; respiratory tract infections; Spinal cord injuries; spinal cord injury; urinary tract infections; spinal cord injury; multidrug resistance; respiratory tract infections; level of injury; urinary tract infections; Hospital acquired infections
• ISSN: 0974-2727; 0974-7826
• DOI: 10.4103/0974-2727.129089

ABSTRACT 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. Aims: The aim of this study is to analyze the primary cause of mortality in SCI patients. Design: Retrospective study. Materials and 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.