Abstract
BackgroundHospital-acquired infection affects hundreds of millions of people worldwide. It is a major global issue for patient safety. Understanding the potential risk factors is important to appreciate the local context. A matched case control study design, which is the first of its kind in the study region, was undertaken to identify risk factors in teaching hospitals of Amhara regional state, Ethiopia.MethodA matched case control study design matched with age and hospital type was used. The study was conducted in University of Gondar and Felege-Hiwot medical teaching hospital. Cases were patients who fulfilled the criteria based on CDC definition of hospital-acquired infection and controls were patients admitted to the hospital that stayed for more than 48 hours in the ward in the study period, but who did not develop infection. For one case, four controls were selected. Of 545 patients, 109 were cases and 436 were controls. Conditional logistic regression using STATA 13 was used for data analysis.ResultThe median length of stay for cases and controls was 7 and 8 days, respectively. Patients admitted in wards with the presence of medical waste container in the room had 82% less chance of developing hospital-acquired infection (AOR 0.18; 95% CI, 0.03–0.98). The odds of developing hospital-acquired infection among immune deficient patients were 2.34 times higher than their counterparts (95% CI; 1.17–4.69). Patients received antimicrobials, central vascular catheter and surgery since admission had 8.63, 6.91 and 2.35 higher odds of developing hospital-acquired infection, respectively.ConclusionHealth providers and mangers should consider the provision and availability of healthcare materials and facilities in all of the ward rooms, follow appropriate safe medical procedures for use of external devices on patients, and give attention to the immunocompromised patients for the prevention and control of hospital-acquired infections.
Highlights
Hospitals are the potential source of the risk of acquiring an infection during the healthcare delivery
Availability of waste management material, immune status of the patient, central vascular catheter, surgery for admission and the patient received antimicrobial at the time of the survey were the predictors of hospital acquired infection
Patients in wards with the presence of medical waste container in the room were 82% less likely to develop hospital acquired infection compared to the patients in the wards without medical waste container with, AOR 0.18: and 95% confidence intervals (CI), (0. 03–0.98)
Summary
Hospitals are the potential source of the risk of acquiring an infection during the healthcare delivery. Hospital-acquired infections(HAIs) are associated with increased attributable mortality, length of stay in the hospital, and healthcare costs incurred by patients and healthcare facilities[1,2]. World Health Organization (WHO) estimated that it affects hundreds of millions of people worldwide and it is a major global issue for patient safety[3]. Risk of hospital-acquired infections increased with invasive devices used [5] for example, for treatment and monitoring of patient in Intensive Care Units (ICU)[6]. Researches in developing countries showed that the DAIs in intensive care unit were high[15,16] and incurred extra cost for patients[17,18,19]. Hospital-acquired infection affects hundreds of millions of people worldwide. It is a major global issue for patient safety. A matched case control study design, which is the first of its kind in the study region, was undertaken to identify risk factors in teaching hospitals of Amhara regional state, Ethiopia
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