Risk factors of nosocomial infections in patients with diabetes admitted to medical surgical and Intensive care units of a Tertiary care Hospital of Karachi, Pakistan

Date of Award

2000

Document Type

Thesis

Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)

Department

Community Health Sciences

Abstract

Diabetes mellitus is one of the leading cause of hospitalization worldwide. In Pakistan the prevalence of diabetes is 11% . The diabetics in this country are most of the time unaware of their disease & hence their blood sugar remains uncontrolled predisposing them to infections when these patients are admitted to the hospital. We conducted this case control study to evaluate the risk factors among patients with diabetes admitted to a tertiary care hospital of Karachi from January 1, 1997 to March 31, 2000. Data were collected on a pre-tested structured questionnaire from 206 cases and 205 controls. CDC's criteria's for diagnosis of nosocomial urinary tract, respiratory tract and blood stream infections were used to identify cases and controls. This data was transferred to Epi-info and analysis was performed by SPSS and Epi-Info. For the variables considered for analysis, multiple logistic regression revealed that age (aOR; 1.04, 95% CI; 1.01-1.07), number of years since diagnosis of diabetes (aOR; 1.13, 95% CI: 1.06- 1.21), elevated fasting blood sugar (mg/dl) (aOR; 3.45, 95% CI 1.85_6.45), and duration of last hospitalization (aOR; 1.14, 95% CI 1.09-1.20), use of central venous catheter (aOR; 3.52, 95% CI 1.63_7-94), diagnostic procedures (aOR; 2.52, 95% CI 1.34-4.52), use of foley's catheter (aOR; 5.76, 95% CI 2.27-14.65) were significant risk factors for acquiring nosocomial infections. Older diabetic patients with longstanding disease and poor glycemic control, recent hospitalization, and invasive device use are more susceptible to nosocomial infections. There is a need of improved hospital care with minimal invasive device use.

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