As vascular access devices are one of the major sources of infections in a hospital setting, Dr Prashant Borade, Head Critical Care Department, Global Hospital opines that to control antimicrobial resistance, healthcare facilities need to invest in all possible ‘care’, including staff training, establishing ‘infection control committees’, and using vascular access devices that can help control the acquisition of infection
The last century saw the immense worth of antibiotics in controlling infections, making humanity complacent. However, the rapid increase in antibiotic resistance has been a matter of serious concern. Antimicrobial resistance is now a global threat to human, animal, and environmental health, owing to the emergence, spread, and persistence of multidrug-resistant (MDR) bacteria or “superbugs.”
Results from studies indicate that patients who acquired MDR bacterial infections were 1.57 times more likely to die, compared to patients with similar susceptible infections, while patients who acquired XDR (extensively drug-resistant) infections were 2.65 times more likely to die when accounting for age, sex, site of infection, and the number of co-infections1.
In India, MDR and XDR bacterial infections are frequent, and the availability of effective
antibiotic therapies are declining. As antibiotic resistance shows no signs of decline, the limelight is now on the prevention of infections.
One of the places where one may pick up an infection is during a hospital stay.
Hospital-acquired infections (nosocomial infections)
Studies from across the world show that in North America and Europe, 5 per cent–10per cent of all hospitalisations result in nosocomial infections. In contrast, Latin America, Sub-Saharan Africa and Asia show more than 40per cent hospitalisations with nosocomial infections. 2 Amongst the hospital-acquired infections, those acquired in the ICU are very high.
The ICU-acquired infection rate is at least 2 to 3-times higher in low – and middle-income countries than in high-income countries, where it’s about 30per cent.3
Device associated infections
In the 2014 fact sheet of WHO,3 it is stated that in the low- and middle-income countries, the device-associated infection densities are up to 13 times higher than in the USA.
In such situations, it is imperative to pay attention to preventive measures that can help bring down the infection rate in hospitals and ICUs, thereby reducing the economic burden on the patient and safeguarding the hospital’s reputation.
Vascular access devices (VADs) are one of the major sources of infections in a hospital setting.
Recently, with an advancement in medicine, some high-quality and reliable vascular access device products are available that include pre-filled saline syringes for flushing catheters. Pre-filled saline syringes are associated with a reduced risk of Catheter-Related Bloodstream Infections (CRBSIs)4.
Their salient features include5:
International guidelines recommend some key practices and ‘care’ to be taken during the use of vascular devices6,7 which include:
International guidelines recommend pre-filled saline syringes for flushing vascular access devices7.
Some specific recommendations while using VADs include8: