Title : Impact of implementation of antimicrobial stewardship (AMSP) and infection prevention and measures (IPC) on MDRO profiles in a tertiary care hospital of India
Abstract:
The study was conducted to gather information to assess the extent of impact of antimicrobial stewardship (AMSP) practices on antimicrobial prescribing patterns and bacterial resistance profiles among indoor patients across ten ICU and non-ICU departments at the Institute of Postgraduate Medical Education and Research, Kolkata. The study protocol was submitted to the Institutional Ethics Committee of the institute and it was approved unanimously. A modified version of the patient case record form (CRF) proposed by WHO-AMSP scale was adopted for validation using standard methodologies. Data from indoor patients were collected prospectively from June, 2022 till October, 2023. The use of antimicrobials was categorized as empiric, prophylactic or targeted/culture driven. The WHO-AWARE classification of antimicrobials was used to classify systemic antimicrobials being prescribed to patients. Study data was archived and analyzed using software such as SPSS 20.0 (IBM), Jamovi and Med Calc 8 (Belgium).Total number of beds covered annually was 2972 and the number of patients on antimicrobials was found to be as high as 98.57 %. Relatively higher numbers of patients were found to be on two or more antimicrobials predominantly from WATCH and RESERVE categories. Interestingly, among nosocomial CLABSI and CAUTI rates were 22.05 % and 22.11 % respectively with a relatively lower proportion of SSIs 0.88%. Mortality relatedness to infection was found to be 48.62 %. The overall compliance rate to hospital antibiotic policy was found to be 72. 51% while culture was sent in nearly 59% of the patients surveyed. Rationality assessment and prospective audit and feedback of antimicrobials was performed which is under analysis. This preliminary study resulted in acquisition of data not only related to resistance profiles of microbial pathogens to antimicrobials but also yielded data about determinants of hospital acquired infection including surgical site infections which may aid policy makers to formulate newer antimicrobial guidelines in the state and country based on such definitive findings.
Audience Take Away Notes:
- Antimicrobial Resistance research in India
- Infection prevention and control
- Antimicrobial Stewardship and its feasibility in LMICs
