Prevalence and risk factors of health care–associated infections in a limited resources country: A cross-sectional study

Abstract

The aim of this study was to determine the prevalence of health care-associated infections (HAI) in our university hospitals (UH) and to delineate the risk factors associated with HAI. We conducted a cross-sectional study in the 2 UH of Sfax, Tunisia on July 2017, including all patients hospitalized for at least 48 hours. It was a 1-day pass per department and a 1-week prevalence survey per UH. Of 752 patients eligible for the study, the total number of HAI was 82, representing an overall prevalence of HAI of 10.9%. Respiratory tract infections were the most prevalent HAI (36.6%). In multivariate analysis, intrinsic risk factors independently associated with HAI were immune-suppression (adjusted odds ratio (AOR) = 2.8; P < .001), diabetes (AOR = 2.2; P = .008), and malnutrition (AOR = 2.2; P = .019). Extrinsic risk factors were endotracheal intubation (AOR = 17; P = .01), transfer to another department (AOR = 9; P = .019), parental feeding (AOR = 7.2; P = .014), tobacco use (AOR = 6.3; P = .004), as well as surgical wound class contaminated or dirty (AOR = 6.3; P = .002), and peripheral venous catheter(AOR = 4.7; P = .006). Our study highlighted the magnitude of the HAI problem threatening the quality of care in Southern Tunisia. A wise identification of HAI risk factors may help health care workers to ascertain the avoidability of these infections.