2472. Point Prevalence of Healthcare-Associated Infections and Antibiotic Use in a Tertiary Care Teaching Hospital in Nepal: A Cross-Sectional Study

Abstract

BackgroundHealthcare-associated infections (HAIs) are a growing threat to patient safety, particularly in resource-limited settings. Information on the burden of HAIs will help in surveillance and prevention efforts. This study aims to estimate the prevalence of HAIs and antibiotics use in a tertiary care teaching hospital in Nepal.MethodsWe conducted a descriptive cross-sectional point prevalence survey in a 350 bedded acute care teaching hospital at Kathmandu, Nepal on April 2019 in a single day for every ward. We studied all the patients aged ≥ 18 years admitted for at least two calendar days on the day of the survey to collect data on patient characteristics, hospital stay, and invasive devices and antibiotics used. We evaluated for the three common HAIs – pneumonia, urinary tract infection and surgical site infection, active on the day of data collection using the clinical criteria by European Center for Disease Prevention and Control protocol version 5.3. We summarized continuous variables with median and interquartile range (IQR) and categorical variables with proportions. We reported the prevalence of HAIs as a proportion of the number of HAIs by the number of patients studied.ResultsOf 213 inpatients, 160 were eligible, 25 (15.6%) among them were from critical care units. The median age was 50 years (IQR 34–65). The median duration of hospital stay was 6 days (IQR 4–9). There were 18 HAIs for the prevalence of 11.25%. Urinary tract infection was the most common HAI (13 HAIs, 72.2% of all HAIs). We found invasive devices used in 42 patients (26.2%), the most common was urinary catheter (37 patients, 23.1%). The number of patients with any antibiotic used was 114 (71.25%) with 61 (38%) patients receiving two or more antibiotics. Third-generation Cephalosporins were the most common antibiotics (74, 64.9%) used. We found 91 (79.8%) patients being treated for community-acquired infections.ConclusionThis study provides an estimate of the burden of HAIs in our center that is comparable to that of the reports from other resource-limited settings. However, we believe a higher burden will be revealed when we add microbiological criteria as well to diagnose HAIs. This highlights an urgent need for HAI surveillance system, infection prevention and control, and antibiotics stewardship programs in our center. Disclosures All authors: No reported disclosures.