Point-prevalence survey of hospital acquired infections in three acute care hospitals in Northern Nigeria

Usman Abubakar

doi:10.1186/s13756-020-00722-9

Abstract

BackgroundEffective infection prevention and control strategies require reliable data describing the epidemiology of hospital acquired infections (HAIs), and this is currently lacking in Nigeria. The objective of this study was to evaluate the prevalence, types and risk factors associated with HAIs in acute care hospitals in Northern Nigeria.MethodsA pilot point-prevalence survey was conducted in three acute care hospitals in Northern Nigeria between April and May 2019 using a protocol developed by the European Centre for Disease Prevention and Control. Patients admitted into the wards at or before 8.00 am on the survey date were included. Patients’ medical records were reviewed by a clinical pharmacist with the support of the attending physician and nurse to identify HAIs.ResultsOf the 321 patients surveyed, 50 HAIs were identified among 46 patients translating into a point-prevalence of 14.3%. The most common HAIs were bloodstream infection (38.0%), surgical site infections (32.0%) and pneumonia (12.0%). Neonatal (53.0%), pediatric surgical (26.7%) and surgical (10.1%) specialties had the highest prevalence. Device associated infections represented 16% of all HAIs including bloodstream infections and pneumonia. Of all the HAIs, 15 (30.0%) were present at the time of admission while 75.5% originated from the current hospitals. Univariate analysis showed that newborn (less than 1 month old) (OR: 4.687 95% CI: 1.298–16.927), intubation (OR: 3.966, 95% CI: 1.698–9.261), and neonatal (OR: 41.538 95% CI: 4.980–346.5) and pediatric surgical (OR: 13.091 95% CI: 1.532–111.874) specialties were significantly associated with HAI.ConclusionThe prevalence of HAI was relatively high compared to other developing countries and was significantly associated with neonatal and pediatric surgical specialties. Hospital infection control strategies should be strengthened to reduce the burden of HAIs.

Highlights

Effective infection prevention and control strategies require reliable data describing the epidemiology of hospital acquired infections (HAIs), and this is currently lacking in Nigeria
Factors associated with hospital acquired infections Univariate logistic regression analysis showed that newborn (OR: 4.687, 95% CI: 1.298– 16.927), intubation during hospitalization (OR: 3.966, 95% CI: 1.698–9.261) and patients in neonatal (OR: 41.538, 95% CI: 4.980–346.500) and pediatric surgical (OR: 13.091, 95% CI: 1.532–111.874) specialties were significantly associated with HAI
The current study revealed that the point-prevalence of HAI was 14.3% with bloodstream and surgical site infections accounting for two-third of all the HAIs

Summary

Introduction

Effective infection prevention and control strategies require reliable data describing the epidemiology of hospital acquired infections (HAIs), and this is currently lacking in Nigeria. The objective of this study was to evaluate the prevalence, types and risk factors associated with HAIs in acute care hospitals in Northern Nigeria. In Europe, about one-third of micro-organisms isolated in HAI are resistant to antibiotics [4]. In Africa, higher rates of antibiotic resistant (10–100%) are reported among isolates from HAIs [5, 6]. Available evidence shows that the prevalence and types of HAI varies among countries with lower rates observed in developed countries. In the United States (US), one in 24 hospitalized patients develops HAI with high rates for pneumonia, surgical site infection (SSI) and gastro-intestinal infections [2]. In Europe, the prevalence of HAI in acute care settings is 6.5% (range 5.4– 7.8%).

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