Abstract
Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries. However, limited information is available about the risk of HAIs in naturally ventilated wards (NVWs) and mechanically ventilated intensive care units (MVICUs) of public hospitals in the Philippines. We aimed to assess the association between HAIs and type of ventilation in an urban tertiary care hospital in the Philippines. A cross-sectional point-prevalence survey of infections was done in NVWs and MVICUs of a tertiary care hospital in December 2013. Multivariate analyses were done to examine the associations between HAIs and type of ventilation and other risk factors. Of the 224 patients surveyed, 63 (28%) patients had 69 HAIs. Pneumonia was the most common HAI (35%). Wards near areas with high vehicular activity had more respiratory HAI cases. Being immunocompromised is a risk factor for HAI for pediatric and adult patients. Among pediatric patients, staying in MVICUs had a lower risk for HAIs (adjusted odds ratio [AOR]: 0.33; 95% confidence interval [CI]: 0.10-1.08) compared to staying in NVWs. For adult patients, a higher risk for HAIs (AOR: 2.41; 95% CI: 0.29-18.20) was observed in MVICUs compared to NVWs. Type of ventilation is not a risk factor for HAIs. Patients who are immunocompromised may be at a higher risk for HAI. Indoor air pollution, proximity to congested main thoroughfare, and increased human foot traffic may contribute to the susceptibility of patients to HAIs. Hospital layout should be considered in infection control.
Highlights
Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries
A higher percentage of patients with hypertension was observed in the mechanically ventilated adult intensive care units (ICUs) compared with the adult wards (69.2% versus 37.8%; p = 0.04), while no difference was observed for diabetics (23.1% versus 25.6%; p = 1.00) and patients who had ever smoked (30.8% versus 34.1%; p = 1.00)
Our previous study on the indoor air quality of Philippine General Hospital (PGH) showed that the concentration of the particulate matter with aerodynamic diameter of 2.5 microns (PM2.5) at the wards was higher and exceeded the World Health Organization (WHO)’s guideline of 25 micrograms/m3 compared to the ICUs of the hospital [16]
Summary
Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries. Limited information is available about the risk of HAIs in naturally ventilated wards (NVWs) and mechanically ventilated intensive care units (MVICUs) of public hospitals in the Philippines. We aimed to assess the association between HAIs and type of ventilation in an urban tertiary care hospital in the Philippines. No pointprevalence studies have been carried out before that examined HAIs in ICUs that are mechanically ventilated and in wards that are naturally ventilated in tertiary healthcare facilities in the Philippines. The aims of this study were to estimate the point prevalence and to evaluate the risk factors of HAIs in primary care wards (naturally ventilated) and in ICUs (mechanically ventilated) of an urban tertiary hospital
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