Background & Aim. Acquired infections in Medical intensive care units have become serious threats with increasing mortality and morbidity more so in the developing countries. The most common reason being lack of efficient infection control protocols.  Critically ill patients are at increased risk of acquiring nosocomial infections because of their lower immune status and the opportunistic characteristics of these microorganisms. This study was conducted to study the association of leukocytosis in relation to nosocomial infections in Medical intensive care units. Methods. A retrospective study was conducted at the Medical Intensive Care Unit (MICU) under the Department of Anesthesiology in collaboration with Department of Microbiology and Department of Pathology over a period of six months. All the patients who were admitted in MICU and stayed for more than 48 hours were included in the present study. Results. A total of 805 patients were admitted in the Medical Intensive Care Unit (MICU) from 1st January to 30th June 2017 for a period of 6 month. Out of 805 cases 27 patients developed nosocomial infections amounting to 3.3% with Male to Female ratio of 2.8:1. The age of the patient ranged from 15 to 85 years with the mean age of 50 years. Male predominance was seen with 74% cases with mean age of 48.5 years. Maximum cases were seen in the geriatric age group mainly 6th to 7th decade comprising of 40.7% of all cases. In our study blood stream infection was the most common finding constituting 100% of the cases, followed by Urinary tract infections. All the cases of nosocomial infections showed Polymorphonuclear Leukocytosis with shift to left. Our study revealed diabetes mellitus and hypertension as the most common cause followed by chronic kidney disease contributing to 29.6%, 29.6% and 22.2% respectively. Urinary catheters (all cases) were the most prevalent invasive device followed closely by Ryle’s tube (90%) and endotracheal tube (60%). Conclusions. Intensive care units comprise of less than 10% of the total hospital beds but contribute > 20% of all the nosocomial infections acquired in the hospital.  World Health organization (WHO) estimates the burden of nosocomial infections in hospitalized patients to be 7-12% globally, in contrast to the figures from India being alarmingly high varying from 11-83%.

 

KEYWORDS: Nosocomial, diabetes, intubation