Original Articles

Comparative Analysis of Healthcare-Associated Infections in Gastroenterology and Gastro surgery: A Two-Year Retrospective Study at GB Pant Hospital, New Delhi

Abstract

Background:   Healthcare-associated infections (HAIs) pose significant challenges in gastroenterology and gastrosurgery. This study aimed to compare infection characteristics between these two patient populations at a tertiary care center in India, focusing on gastro-specific samples.

Methods:   We conducted a retrospective observational study of 824 patients (412 each in gastroenterology and gastrosurgery) over 24 months at GB Pant Hospital, New Delhi. Infections were defined using CDC criteria. Microbiological identification and antimicrobial susceptibility testing were performed on gastro-specific samples. Risk factors were analyzed using multivariate logistic regression.

Results:    Infection rates were significantly higher in gastrosurgery patients (18.4% vs. 7.5%, p<0.001). Escherichia coli was the predominant pathogen in both groups (gastroenterology: 30.6%, gastrosurgery: 28.9%). Antimicrobial resistance was more prevalent in gastrosurgery isolates, with 48.7% ESBL-producing Enterobacteriaceae compared to 27.3% in gastroenterology. Independent risk factors for infection differed between groups, with proton pump inhibitor use significant in gastroenterology (OR 2.3, 95% CI 1.5-3.5) and prolonged operative time in gastrosurgery (OR 2.8, 95% CI 1.9-4.2).

Conclusion:   Significant differences in infection profiles between gastroenterology and gastrosurgery patients necessitate tailored prevention and treatment strategies.

1. Magill SS, O'Leary E, Janelle SJ, et al. Changes in Prevalence of health care-associated infections in U.S. Hospitals. N Engl J Med 2018; 379(18):1732-44.
2. Allegranzi B, Bagheri Nejad S, Combescure C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011; 377(9761):228-41.
3. Petersen AM, Krogfelt KA. Helicobacter pylori: an invading microorganism? A review. FEMS Immunol Med Microbiol 2003; 36(3):117-26.
4. World Health Organization. Report on the Burden of Endemic Health Care-Associated Infection Worldwide. Geneva: WHO; 2011. [No DOI - Institutional Report]
5. Razine R, Azzouzi A, Barkat A, et al. Prevalence of hospital-acquired infections in the university medical center of Rabat, Morocco. Int Arch Med 2012; 5(1):26.
6. Singh S, Chakravarthy M, Rosenthal VD, et al. Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC). Int Health 2015; 7(5):354-9.
7. Klevens RM, Edwards JR, Richards CL Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007; 122(2):160-6.
8. Zarb P, Coignard B, Griskeviciene J, et al. The european centre for disease prevention and control (ecdc) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Euro Surveill 2012; 17(46):20316.
9. Centers for Disease Control and Prevention. National Healthcare Safety Network (NHSN) Patient Safety Component Manual. Atlanta, GA: CDC; 2023. [No DOI - Institutional Manual]
10. Clinical and Laboratory Standards Institute. M100 Performance Standards for Antimicrobial Susceptibility Testing. 31st ed. Wayne, PA: CLSI; 2021. [No DOI - Standards Document]
11. Bizzini A, Greub G. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry, a revolution in clinical microbial identification. Clin Microbiol Infect 2010; 16(11):1614-9.
12. Clinical and Laboratory Standards Institute. M02 Performance Standards for Antimicrobial Disk Susceptibility Tests. 13th ed. Wayne, PA: CLSI; 2018. [No DOI - Standards Document]
13. Clinical and Laboratory Standards Institute. M100 Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. Wayne, PA: CLSI; 2020. [No DOI - Standards Document]
14. de Lissovoy G, Fraeman K, Hutchins V, et al. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009; 37(5): 387-97.
15. Kaye KS, Schmit K, Pieper C, et al. The effect of increasing age on the risk of surgical site infection. J Infect Dis 2005; 191(7):1056-62.
16. Laxminarayan R, Duse A, Wattal C, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis 2013; 13(12):1057-98.
17. Palavutitotai N, Jitmuang A, Tongsai S, et al. Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. PLoS One. 2018; 13(2):e0193431.
18. Livermore DM, Canton R, Gniadkowski M, et al. CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemother 2007; 59(2):165-174.
19. Pitout JD, Laupland KB. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis 2008; 8(3):159-66.
20. Kwon JH, Olsen MA, Dubberke ER. The morbidity, mortality, and costs associated with Clostridium difficile infection. Infect Dis Clin North Am 2015; 29(1):123-34.
21. Rerknimitr R, Fogel EL, Kalayci C, et al. Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis. Gastrointest Endosc 2002; 56(6):885-9.
22. Leaper DJ, Tanner J, Kiernan M, Assadian O, Edmiston CE Jr. Surgical site infection: poor compliance with guidelines and care bundles. Int Wound J 2015; 12(3):357-62.
23. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg 2017; 224(1):59-74.
IssueVol 13 No 2 (2025) QRcode
SectionOriginal Articles
Keywords
Antimicrobial resist-ance Gastro-enterology Gastro surgery Healthcare-associated infections Risk factor.

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How to Cite
1.
Goenka S, Singh A, Reshi S, Loomba P, Manisha Jain M, Sharma A, Tyagi S. Comparative Analysis of Healthcare-Associated Infections in Gastroenterology and Gastro surgery: A Two-Year Retrospective Study at GB Pant Hospital, New Delhi. J Med Bacteriol. 2025;13(2):9-15.