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Abstract
Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face. The recorded interviews were transcribed verbatim and analyzed by qualitative content analysis with an inductive and deductive approach. The participants acknowledged risk factors of HAI and ABR development, such as patient behavior, high numbers of injured patients, limited space, and non-compliance with hygiene protocols, but did not express a sense of urgency or any course of action. Overuse and misuse of antibiotics were reported as main contributors to ABR development, but participants expressed no direct interrelationship between ABR and HAI. We conclude that due to high patient load and limited resources, physicians do not see HAI as a problem they can prioritize. The knowledge gained by this study could provide insights for the allocation of resources and development of hygiene and wound treatment protocols in resource-limited settings.
Highlights
Healthcare-associated infections (HAIs) constitute a major threat to patient safety worldwide by prolonging hospital stay, elevating rates of morbidity and mortality, and greatly increasing the financial burden [1]
The theme presents factors related to the development of HAI and antibiotic resistance (ABR), as well as their consequences
The theme emerged from two categories: (i) Healthcare-associated infections, and (ii) antibiotic resistance (Table 2)
Summary
Healthcare-associated infections (HAIs) constitute a major threat to patient safety worldwide by prolonging hospital stay, elevating rates of morbidity and mortality, and greatly increasing the financial burden [1]. Hundreds of millions of patients are affected by HAIs annually, with higher rates in low- and middle-income countries (LMICs) [2,3]. In these countries, patients and healthcare workers are vulnerable to HAIs and its consequences due to understaffing, overcrowding, and shortage of basic equipment such as gloves [4,5]. Public Health 2018, 15, 2709; doi:10.3390/ijerph15122709 www.mdpi.com/journal/ijerph
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