A Review of Nosocomial Infection at the Lagos university Teaching Hospital: Problems and Strategies for Improvement.

Abstract

The infection control program of the Lagos Universityteaching hospital was started in 1974 with an Infection Control team reporting to an Infection Control Committee. There is currently no functioning Infection Control Committee. An analysis of data of a hospital- wide surveillance obtained between November 1993 - November 1996 is presented, highlighting the problems associated with maintaining an effective infection control Programme in a developing economy and discussing possible solutions. The monthly prevalence ranged between 0.11 - 8.1% for nosocomial infections with a 14:1 ratio of gram- negative organism. Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli were the most common pathogens accounting for 75% of all organisms isolated. The prevalence of Staphylococcus aureus was only 4.8% of all isolates and that of hospital - acquired Plasmodium falciparum was 6.2%. urinary tract infections were the most common nosocomial infections and were often catheter related. These were followed by wound infections of which 55.2%were surgical site infections. Nosocomial respiratory tract and bloodstream infections appear uncommon. Lack of an Infection Control Committee, lack of an effective antibiotic policy, poor funding, inadequate and ageing infrastructure including poor water supply and a lack of awareness of the cost benefits of an efficient Programme have been identified as some of the problems mitigating against an effective infection control Programme in the hospital. Journal of the Nigerian Infection Control Association Vol. 1 No. 1 (Oct 1998): pp 11-13 Key Words : Nosocomial, Surveillance, Problems.