Epidemiology and Burden of Infectious Diseases in a Tertiary Care Hospital

Ayesha  Saddique; Sara  Malik; Shehlla  Qadir; Romaisa  Khalid; Aamena  Gardazi; Uzma  Arshad

doi:10.36283/ziun-pjmd14-4/071

Authors

Ayesha Saddique Assistant Professor, Community Medicine, Multan Medical & Dental College, Multan.
Sara Malik Associate Consultant. Internal Medicine. Mukhtar A Sheikh Hospital Multan.
Shehlla Qadir Assistant Professor. Community Medicine. Multan Medical & Dental College, Multan.
Romaisa Khalid Senior Registrar. Medicine department, Bakhtawar Amin trust and teaching hospital, Multan.
Aamena Gardazi Assistant Professor of Medicine. Bakhtawar Amin teaching hospital. Multan.
Uzma Arshad Associate Professor Community Medicine. Multan Medical & Dental College, Multan.

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/071

Keywords:

antimicrobial resistance, hospital-acquired infections, nosocomial infections, sepsis, seasonal variation

Abstract

Background: Infectious diseases remain a significant cause of morbidity and mortality, particularly in low- and middle-income countries. Tertiary care hospitals face increasing challenges from antimicrobial resistance and healthcare-associated infections, necessitating localized epidemiological data for effective management. The study aimed to determine the epidemiology and clinical burden of infectious diseases at Bakhtawar Amin Hospital, Multan, Pakistan, identifying high-risk populations, seasonal trends, and predictors of mortality.

Methods: A cross-sectional analytical study was conducted from January 2023 to December 2024. A total of 334 adult inpatients with confirmed infectious diseases were included. Data were extracted from medical records using ICD-10 codes. Variables included demographics, diagnosis, seasonality, antimicrobial use and outcomes. Statistical analysis was performed using SPSS version 26.0.

Results: The mean age was 48.6 ± 16.4 years; 54.8% were male. Respiratory tract infections (34.4%) were most common, followed by urinary tract (18.6%) and gastrointestinal infections (13.2%). Summer saw the highest admissions (31.1%), while winter showed peak respiratory illness (42.6%). Nosocomial infections accounted for 21.3% of cases. Antimicrobial use was high, with 22.5% of isolates being multidrug-resistant. Mortality was 16.2%, with age >60 years and diabetes as independent predictors of death.

Conclusion: Infectious diseases significantly burden tertiary care services, especially among older adults and diabetics. Targeted infection control, antimicrobial stewardship, and surveillance are critical to mitigating this burden.

References

1. World Health Organization. Global Health Estimates 2021: Disease burden by cause, age, sex, by country and by region, 2000-2019. Geneva: World Health Organization; 2021.

2. Murray CJL, Lopez AD. Global burden of infectious diseases in 2021: A call for improved data integration. Lancet Glob Health . 2022;10(1):e1-e2.

3. Singh S, Chauhan LS, Rao RV. Burden of infectious diseases in India: Insights from the Million Death Study. Indian J Public Health . 2021;65(Supplement):S1-S7.

4. Mehta Y, Gupta A, Todi SK. Nosocomial infections in ICU—a review of epidemiology, causes, challenges, and prevention. Indian J Crit Care Med. 2020;24(Suppl 3):S262-S272.

5. World Health Organization. Healthcare-associated infections fact sheet. Geneva: WHO; 2020.

6. GBD 2019 Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet. 2022;399(10325):629-655.

7. Bhattacharya S, Dasgupta R, Datta S. Regional variation in disease patterns and its implications for public health planning in India. J Family Med Prim Care. 2021;10(11):3945-3951.

8. Anandan S, Veeraraghavan B, Devanga Ragupathi NK. Seasonal variation and molecular characterization of bacterial pathogens in a tertiary care hospital in South India. J Infect Public Health. 2021;14(10):1389-1396.

9. Panda S, Samantaray JC, Kumar A. Emerging trends in infectious disease epidemiology in India: A narrative review. J Epidemiol Glob Health. 2020;10(3):155-162.

10. Sharma S, Goel N, Kaushik R. Climate change and infectious diseases: Impact on Indian subcontinent. Indian J Med Res. 2021;154(4):475-486.

11. Khan S, Ali A, Ahmed A, et al. Spectrum of infectious diseases among adult inpatients at a tertiary care hospital in Lahore, Pakistan. J Coll Physicians Surg Pak . 2022;32(5):567-571.

12. Ahmed S, Farooq U, Raza A. Spectrum of infectious diseases in hospitalized adult patients at a tertiary care hospital in Islamabad. J Pak Med Assoc. 2023;73(4):789-794.

13. Iqbal M, Khan MA, Rehman AU. Seasonal variation and clinical outcomes of respiratory infections in a tertiary care hospital in Lahore. Pak J Med Sci. 2022;38(3):678-683.

14. Zafar A, Saleem S, Siddiqui FJ. Infectious disease burden in the elderly population: A cross-sectional study from Karachi. BMC Geriatr. 2021;21(1):1-8.

15. Hussain A, Aslam M, Qureshi AM. Gender disparities in healthcare-seeking behavior for infectious illnesses in urban Pakistan. Int J Environ Res Public Health. 2022;19(12):7321.

16. Malik MN, Ashraf M, Javaid K. Nosocomial infections in intensive care units: A multicenter study from Pakistan. J Hosp Infect. 2021;117:45-52.

17. Waheed Y, Akhtar S, Saleem K. Antimicrobial resistance trends in tertiary care hospitals across Pakistan: A multi-center surveillance report. Antibiotics (Basel). 2022;11(9):1234.

18. Ali SM, Naqvi SA, Abbas SF. Impact of comorbid diabetes on outcomes in septic patients: A cohort study from Rawalpindi. Diabetes Metab Syndr. 2023;17(2):102651.

19. Khan SU, Azam SI, Khurshid U. Risk factors for mortality in adult inpatients with sepsis: A retrospective analysis from Pakistan. PLoS One. 2021;16(10):e0258123.