Prevalence of Traumatic Brain Injury and Associated Infections in a Trauma Center in Northern India

Mitra Kar; Chinmoy Sahu; Pooja Singh; Kamlesh Singh Bhaisora; Nidhi Tejan; Sangram Singh Patel; Ujjala Ghoshal

doi:10.4103/jgid.jgid_66_23

Prevalence of Traumatic Brain Injury and Associated Infections in a Trauma Center in Northern India

J Glob Infect Dis. 2023 Nov 30;15(4):137-143. doi: 10.4103/jgid.jgid_66_23. eCollection 2023 Oct-Dec.

Authors

Mitra Kar¹, Chinmoy Sahu¹, Pooja Singh¹, Kamlesh Singh Bhaisora¹, Nidhi Tejan¹, Sangram Singh Patel¹, Ujjala Ghoshal¹

Affiliation

¹ Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Abstract

Introduction: One of the rapidly escalating public health problems worldwide is traumatic brain injury (TBI) due to road traffic accidents. In comparison to postneurosurgery patients and other patients inhabiting the intensive care units (ICUs), patients with TBI are more susceptible to nosocomially acquired infections from the hospital milieu.

Methods: This retrospective study was conducted at a university hospital in Northern India from December 2018 to September 2022. All patients presenting with TBI formed the cohort of our study population.

Results: A total of 72 patients with TBI were enrolled. The mean age of patients was 40.07 ± 18.31 years. The most common infections were ventilator-associated pneumonia (VAP) (44/72, 61.11%) and bloodstream infection (BSI) in 21 (21/72, 29.17%) patients. Concomitant infections were observed in 21 (21/72, 29.17%) patients. The common organism causing VAP was Acinetobacter spp. (29/58, 50.0%), BSI was Klebsiella pneumoniae (10/23, 43.48%), urinary tract infection was K. pneumoniae (5/16, 31.25%), and surgical site infection was Acinetobacter spp. (3/8, 37.5%) in TBI patients. An increased incidence of multidrug resistance was demonstrated in our patients. The increased length of hospital and ICU stay, ICU admission, intubation, diabetes mellitus, chronic kidney disease, and hypertension were statistically significant parameters that made TBI patients prone to develop an infection.

Conclusion: TBI patients suffering from underlying comorbidities are prone to develop infections with multidrug-resistant bacteria was observed among our study cohort which also mirrors the lack of adherence to infection control measures.

Keywords: Bloodstream infection; drug resistance; infection control; intensive care units; traffic accidents; traumatic brain injury; ventilator-associated pneumonia.