HAIs IN CCUs AN OVERLOOKED BURDEN

HAls are a silent threat in India's CCUs, where fragile patients face life-or-death stakes. Preventable yet persistent, these infections undermine the progress of advanced heart care. Can India make cardiac healing truly safe?

- By Kalyani Sharma

Hospital Acquired Infections (HAIs) have long been recognised as one of the concern in modern healthcare. These infections are seen across multiple hospital settings, but their impact is particularly devastating in Cardiac Care Units (CCUs).

Cardiovascular disease is the leading cause of death in India. With rise in demand for advanced cardiac care, tackling HAIs in cardiac units has become a matter of urgency.

Burden of HAIs in India: Scale of the problem

CCU patients are already fragile, recovering from major surgeries or on invasive devices. For them, an infection is not just an added complication but can be life-threatening. Infections such as ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSI) prolong hospital stays, escalate treatment costs, and significantly increase the risk of mortality.

Dr Anil Kumar, HOD and Senior Consultant-Medical ICU, Sharda Care Healthcity, explains that, cardiac surgery ICUs (post-cardiac surgery units) differ from medical CCUs in their HAI profile because patients are highly invasive-device dependent in the immediate post-op period.

He also mentions, “Indian studies show 4-10 per cent incidence of HAIs after cardiac surgery, higher than medical CCUs (~1 per cent). Device-associated infections remain the main contributors because nearly all patients require mechanical ventilation, central venous lines, arterial lines, urinary catheters, and pacing wires. Mortality and morbidity are significantly increased when HAI occurs in post-cardiac surgery patients, especially due to mediastinitis and bloodstream infections.”