Hospital acquired Infections among patients admitted to Felege Hiwot Referral Hospital, Bahir dar, North West Ethiopia
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Date
2009-12
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Addis Ababa University
Abstract
Back ground: Despite advances in the control and prevention of nosocomial infections, it continues to remain a major affectation in hospital treatment and contribute significantly to the high rate of morbidity, mortality and the health care of hospitalized patients in different parts of the world.
Methods : A prospective observational study with the aim of the study to determine the prevalence of hospital acquired bacterial infection and their antimicrobial susceptibility was conducted from April to August, 2009 at Felege Hiwot Referral Hospital, Bahir Dar. One thousand three hundred-eighty three patients, who had been admitted to surgical, Gyaenacology and Obstetrics wards were included in this study were subjected to follow up
the diagnosis for HAI. Routine conventional microbiological diagnosis (Culture, biochemical tests, gram staining and antibacterial sensitivity)were done for isolation of pathogens from HAI patients. The questionnaire ---- were used for socio demographic data and to assess associated risk factors. Antibiotic susceptibility tests were done by using the standard Kirby Bauer disc diffusion method.
Results: Among the total 1383 observed patients, 246 developed HAI with a prevalence of 17.8 %. The types of hospital acquired infections were UTI, 118 (48 %), SSI, 112(45.6%), BSI, 9(3.7%), pneumonia, 4(1.6%), and 3 (0.3%) developed mixed infections. Among the types of HAI UTI was the predominant followed by SSI and then BSI and pneumonia were the least type of HAI. Certain primary data collected from the HAI patients who were
predispose to conditions like operation procedures, use of catheter, underlying diseases, antibiotics prophylaxis and length of hospital stay contributed as high risk factors based on statistical significance (P= 0.0001). among the patients population. Gram negative bacteria were the predominant organisms with 52.6% compared to gram positive bacteria 47.4%. The
predominant 49(37.1%)bacteria observed was E. coli when compared to other organisms such as K pneumoniae 36 (27.3%), P.aeruginosae 26 (19.7% ,P. mirabilis 10(7.6%), Enterobacter species 4 (3% )P. vulugaris 3 (2.3%)and both Acinetobacter baumannii and S.marcescens each accounted 2(1.5%) whereas among gram positive bacteria, S. aureus 91(76.5%) was the commonest isolate followed by CoNS 18 (15.1% ), and Enteroccocusspecies 10 ( 8.4%). Most of the isolates were resistant to commonly prescribed antibiotics. Methicillin resistance S. aureus was for 94.5% and ampicillin resistance was 98.4%.
Conclusion: UTI, 118(48%)was the commonest Hospital acquired infection. SSI, (87.5%)was the commonest hospital acquired infection in surgical ward where as UTI, 58 (49.2)was the commonest HAI in obstetrics ward. Gram negative bacterial isolates were the predominant etiologies with intermediate to high resistance to commonly prescribed antibiotics
Recommendation: Further studies are needed involving all wards including medical and pediatrics ward, as well as other causative agents anaerobic bacteria, fungal agents etc Organizing an effective infection prevention program in the hospital and continous monitoring and evaluation are essential.
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Keywords
Hospital Acquired Infections, Surgical Site Infections, Urinary Tract Infections, Blod Steam Infections , Antibiotic Susceptibility and Bahir Dar, Ethiopia.