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Addis Ababa University Libraries Electronic Thesis and Dissertations: AAU-ETD! >
Faculty of Medicine >
Thesis - Medical Microbiology >
Please use this identifier to cite or link to this item:
http://hdl.handle.net/123456789/2889
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| Title: | susceptibility patterns in surgical wards and surgical Intensive care unit (SICU) of Tikur Anbessa University Hospital Addis Ababa, Ethiopia. |
| Authors: | Nigatu, Endalafer |
| Advisors: | Dr. Solomon Gebre-Selassie |
| Keywords: | Nosocomial infection, Surgical Site Infection,
Intensive Care Unit
Urinary Tract Infection
Blood Stream Infection |
| Copyright: | Aug-2008 |
| Date Added: | 10-May-2012 |
| Publisher: | AAU |
| Abstract: | Background: Nosocomial infections are defined as infections which are not present or not
incubating when the patient is hospitalized and are acquired during hospital stay. Sign and
symptoms of the infection may be evident during hospitalization or after discharge related to
the length of the incubation period. It is usually defined as an infection that is identified at
least 48-72 hours following admission to health institution. Infections acquired in hospital
are likely to complicate illness, cause anxiety and discomfort, and can lead to death.
Nosocomial infection is a global problem with multi facet out comes. The problem is well
pronounced in developing countries. Epidemiological and etiological characteristics of
nosocomial infections show variations among countries and even among different hospitals
in the same country. Many of these infections are associated with micro-organisms that are
resistant to multiple antibiotics and can easily spread on the hands of personnel. The most
frequent types of nosocomial infections are urinary-tract infection, surgical-wound infection,
pneumonia, and bloodstream infection. At present, the emergence of resistance to
antimicrobial agents is a global public health problem, particularly in pathogens causing
nosocomial infections. Antimicrobial resistance results in increased morbidity, mortality and
health-care costs.
Objective: To determine the prevalence, etiological agents and drug susceptibility pattern of
nosocomial infections at Tikur Anbessa University Hospital.
Methods: A cross-sectional study was conducted from June 2007 to April 2008 at Tikur
Anbessa University Hospital, Addis Ababa, Ethiopia. During the study, all adult patients
admitted to surgical wards and SICU with suspected of nosocomial infection were included.
Among 854 patients admitted to surgical wards and SICU, 215 patients selected based on
their clinical ground, after a careful clinical examination. Clinical samples were collected
from the study subject and analyzed accordingly.
Results: Eight hundred fifty four patients admitted to surgical ward and SICU between June
2007 and April 2008 to Tikur Anbessa University Hospital in Addis Ababa were studied for
prevalence of nosocomial infections. A total of 215(25.2%) patients, were selected based on
their clinical grounds from surgical wards (n=161) and SICU (n=54). The mean hospital stay
from the date of admission until sample collection was 16.72 days with a range of 3 to 66
days. Of the 215 patients, 130(60.5%) were males and 85 (39.5%) were females. A total of
nine percent (77/854) patients were confirmed to have nosocomial infections. Of the 77
patients, 51(66.2%) were males and 26(33.8%) females. The distribution of nosocomial
infections among positive cases was surgical site infection 38(49.4%), urinary tract
infections 23(29.8%) and blood stream infection 16(20.8%). The Gram-positive and
negative bacteria accounted for 23/84(23.4%) and 61/84(72.6%) respectively. A total of 84
bacterial pathogens (strains) were isolated, E. coli accounted for 19.0% of the total isolates
followed by S. aureus and Klebseiella spp. More than one bacteria etiologic agent was
isolated from 7/77(9.1%) of the patients with nosocomial infection. Gram positive bacteria
showed 100% resistance to penicillin, ampicillin, tetracycline, chloramphenicol, and
trimethoprim-sulphamethoxazole; while gram negative bacteria showed 100% resistance to
amoxicillin, Tetracycline and Trimethoprim-sulphamethoxazole.
Conclusion: The prevalence of nosocomial infection at Tikur Anbessa University Hospitals
decreased from the previous study (16.4% and 13%) in the same hospital. Gram-positive
bacteria isolated from nosocomial infection were 100% resistance to Ampicillin,
Tetracycline, Trimethoprim-sulphamethoxazole and Chloramphenicol. In addition, gram-
negative bacterial isolates were 100% resistance to Amoxicillin, Tetracycline and
Trimethoprim-sulphamethoxazole. Due to the presence of high level drug resistance
bacteria, empirical treatment to nosocomial infections may not be effective. Therefore,
treatment should be based on the result of culture and sensitivity. |
| URI: | http://hdl.handle.net/123456789/2889 |
| Appears in: | Thesis - Medical Microbiology
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