Device-Associated Hospital-Acquired Infections in ICU and HDU: A Cross-Sectional Study

Abstract

Background: Hospital-acquired infections (HAIs), particularly device-associated infections, continue to be a major cause of preventable morbidity and mortality in critical care settings. Intensive Care Units (ICUs) and High Dependency Units (HDUs) are especially vulnerable due to frequent use of invasive devices and prolonged hospital stays.

Objective: To determine the incidence and pattern of device-associated hospital-acquired infections in ICU and HDU settings of a tertiary care government hospital and to assess microbiological profiles and sample contamination rates.

Methods: A cross-sectional observational study was conducted over two months in the ICU and HDU of the Medicine Department. Device-days for urinary catheters, central venous lines, and ventilators were recorded. CAUTI, CLABSI, and VAP rates were calculated per 1000 device-days using standardized definitions. Microbiological culture reports were analyzed, and data were subjected to descriptive statistical analysis.

Results: Hospital-acquired infections were observed in 8.4% of admitted patients. Device-associated infection rates were CAUTI 3.37%, CLABSI 2.50%, and VAP 2.53%, with higher rates observed in ICU compared to HDU. Gram-negative organisms predominated, including Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. Sample contamination rates were notably high, reflecting gaps in aseptic collection practices.

Conclusion: The findings highlight a substantial burden of device-associated HAIs in critical care units. Strengthening infection prevention bundles, improving sample collection practices, and reinforcing antimicrobial stewardship are essential to reduce HAI rates in resource-limited tertiary care settings.