SCTIMST DSpace

Digital repository of Sree Chitra Tirunal Institute for Medical Sciences and Technology(SCTIMST), Trivandrum.

This repository is for SCTIMST's research, including project reports, theses, publications and more...

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The Key Performance Indicators(KPI) for Hospital Infection Control
(SCTIMST, 2025-08-30) Preena V
The NABH guidelines for key performance indicators will be discussed, what we have achieved, and the gaps in achievement that need to be addressed.
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The Silent Threat- Infections of the Pacemaker and Beyond
(SCTIMST, 2025-08-30) Shilpa Mohan
Cardiac implantable electronic device (CIED)-associated infections are major causes of concern, with an infection rate of 1-2%.These infections can range from localised pocket generator site (PG Site) infections to systemic infections like Lead Endocarditis(LE). We conducted a retrospective study over 2 years (2023-2025) that included CIED such as Permanent Pacemakers (PPI), Cardiac Resynchronization Therapy devices (CRT), and Intracardiac Defibrillators (ICD).This study describes the clinical presentation, risk factors, microbiological spectrum, management strategies, and outcome in a series of 24 patients with pocket generator (PG) site infections. Knowledge of these variables aids the treating team in early clinical diagnosis, microbiological correlation, and timely intervention, which have to go hand in hand to ensure successful patient outcomes.
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Estimating Standardized Infection Ratio for Surveillance of Surgical Site Infection in Patients Undergoing Craniotomy
(SCTIMST, 2025-08-30) Lakshmi Natarajan
Surgical site infections (SSI) are presented as SSI rates in most of the healthcare facilities. The National Healthcare Safety Network (NHSN) initiated the transition from SSI rates to Standardized Infection Ratio (SIR) calculated by statistical models that include perioperative factors. Method of standardization controls the differences between population in terms of their demographics and other characteristics that confound their comparison. Summary measure of a hospital’s performance can be determined per procedure using SIR. In this study SIR is used for surveillance of SSI following craniotomy.
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Post-neurosurgical Meningitis
(SCTIMST, 2025-08-30) Kavita Raja
Post neurosurgical meningitis (PNM) is an organ space infection type of Surgical Site infection (SSI) and may be accompanied by Superficial or deep wound site infection. This can occur after Craniotomy, craniectomy or after External drainage device insertion. It is defined as an SSI only when it occurs within one month after the initial surgery or within one year after an implant is placed. The signs and symptoms are the same as for community acquired meningitis, but due to the surgery, signs like neck stiffness may be difficult to elicit . The major risk factors for PNM are discussed along with three case studies. Role of the laboratory: Microbiology of PNM is discussed with common organisms that cause infection, both in literature and within the institute. Data from SCTIMST is discussed. A short discussion on Pharmaco kinetics and dynamics of antibiotics in the CSF, with optimum doses of all antibiotics used in meningitis. Accurate biochemical values to monitor progression. Some of the biomarkers that can be monitored in serum and CSF are: Procalcitonin, Lactate, IL-2. However, the studies are still going on to fix the cut-off levels for these. Prevention and surveillance: Surveillance of PNM is the integral part of any hospital infection control surveillance programme. Any increase in numbers or clustering of cases should be investigated 1. Adherence to Definition of SSI to be confirmed for each infection reported 2. Patient population selected 3. Any increase in pre-op stay 4. Eradication of any infection inother sites pre-operatively 5. Surgical antimicrobial prophylaxis to include antibiotics used to manage existing infective processes elsewhere. 6. SAP to be stopped in 48hrs. 7. No role for nasal Mupirocin established yet. 8. Standard Infection ratio is the new statistic being used. 9. Prudent use of antibiotics and standard infection control practices form the mainstay Take home message: 1. Risk factors discussed to be avoided 2. Laboratory guidance for Antibiotic choice is essential. Intra-thecal approach and right knowledge of PK-PD 3. Surgical antimicrobial prophylaxis(SAP) only for 48hrs. For existing infection add the antibiotic as SAP 4. SIR is a new mode of expressing SSI based on risk stratification 5. Biomarkers in CSF are being studied for monitoring of progress.
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