Management of hospital-acquired infections among patients hospitalized at Zewditu memorial hospital, Addis Ababa, Ethiopia: A prospective cross-sectional study.

Segen Gebremeskel Tassew,Workineh Shibeshi,Minyahil Alebachew Woldu,Wondwossen Amogne Degu,Sandra C Buttigieg

doi:10.1371/journal.pone.0231949

Segen Gebremeskel Tassew, Workineh Shibeshi + Show 3 more

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https://doi.org/10.1371/journal.pone.0231949

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Journal: PloS one	Publication Date: Apr 24, 2020
Citations: 6	License type: CC BY 4.0

Affiliation: Addis Ababa University

Abstract

BackgroundHospital-Acquired Infections (HAIs) are acquired when the patient is hospitalized for more than 48 hours. In Ethiopia data are scarce in management appropriateness of HAIs. Hence, this study was aimed to assess the prevalence and management of HAIs among patients admitted at Zewditu Memorial Hospital.MethodA facility based prospective cross sectional study was conducted from March 1, 2017 to August 30, 2017. The sample was proportionally allocated among (medical, pediatrics, gynecology and obstetrics and surgical) wards, based on patient flow. Data were collected using data abstraction format and supplemented by key informant interview. Interview was made on eight physicians and four microbiologists who have been working in the wards during study period. Management appropriateness was assessed using Infectious Disease Society of America guideline and experts opinion (Infectious disease specialist). A multivariate logistic regression was used to identify factors associated with HAIs.ResultThe prevalence of HAIs was 19.8%. Surgical Site Infection (SSI) and pneumonia accounted for 20 (24.7%) of the infections. Culture and sensitivity was done for 24 (29.6%) patients. Of the 81 patients who developed HAIs, 54 (66.67%) of them were treated inappropriately. Physicians’ response for this variation was information gap, forgetfulness, affordability and availability issue of first line medications. Younger age (AOR (Adjusted odds ratio) = 8.53, 95% CI: 2.67–27.30); male gender (AOR = 2.06, 95% CI: 1.01–4.22); longer hospital stay (AOR = 0.17, 95% CI: 0.06–0.51); and previous hospital admission (AOR = 3.22, 95% CI: 1.76–5.89); were independent predictors of HAIs.ConclusionPrevalence of HAIs and inappropriate management were substantially high in this study. Pneumonia and SSI were the common types of HAIs. Locally conformable guidelines could help to correct such problems.

Highlights

Prevalence of Hospital-acquired Infections (HAIs) and inappropriate management were substantially high in this study
Pneumonia and Surgical Site Infection (SSI) were the common types of HAIs
Hospital-acquired Infections (HAIs) or nosocomial infections are defined as infections which are not present or not incubating when the patient is hospitalized and are acquired after 48 hours of hospital stay [1]

Summary

Introduction

Hospital-acquired Infections (HAIs) or nosocomial infections are defined as infections which are not present or not incubating when the patient is hospitalized and are acquired after 48 hours of hospital stay [1]. HAIs prolong hospital stays, create long-term disability, increased patient morbidity and mortality, increase resistance to antimicrobials and represent a massive additional financial burden for health systems [5,6,7]. Such infections annually account for 37, 000 attributable deaths in Europe and they account for 99,000 deaths in the USA, reflecting 16 million extra days of hospital stay. In Ethiopia data are scarce in management appropriateness of HAIs. this study was aimed to assess the prevalence and management of HAIs among patients admitted at Zewditu Memorial Hospital

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