Healthcare-associated infections in three hospitals in Dschang, West Region, Cameroon

Abstract

Background: There is a dearth of knowledge on healthcare-associated infections (HAIs) in Cameroon. This study scrutinized HAI prevention and burden in three hospitals in Dschang, West Region of the country, in order to inform on current practices. Materials and Methods: From September 2008 to April 2009, patient records in three hospitals were assessed, questionnaires administered, and hand washing examined in 29 consenting nurses. A retrospective study on nosocomial infections (NIs) was performed by reviewing the records of 12917 in-patients who survived longer than 72 hours and were not transferred to other hospitals. Modified National Healthcare Safety Network protocols were employed and data analyzed using SPSS. Results: Study respondents (77%, P 0.0089) were aware of HAI control but lacked detailed knowledge including the five moments for hand hygiene. Of 35 staff evaluated, 74% (P 0.0093) used non-disposable hand towels, 9% disposable and a further 9% air-dried hands after washing. An alarming 72% of hand cultures grew coagulase-negative staphylococcus, Enteroccocus, Bacillus, fungi, Klebsiella, Enterobacter and other coliforms indicating fecal contamination. NI rates averaged 2.6 infections/100 admissions and four infected patients/1000 patient days; 17.4% and 12 infected patients/1000 days in surgical patients. Surgical site (38%), respiratory (26%), gastrointestinal (19%), bloodstream (8%) and urinary (7%) infections were predominant NIs, with a mean development time of 7-11 days and prolonged hospital stay by 12 days. Cost constraints precluded routine culture and antibiotic susceptibility testing; thus no data on clinical pathogens. Conclusion: Scrupulous hand hygiene and rub usage, adequate care facilities, staff education and HAI surveillance were paramount.