Incidence of healthcare-associated infections with invasive devices and surgical procedures in Nepal.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2021-11-01 DOI:10.5588/pha.21.0039

P Koju, X Liu, R Zachariah, M Bhattachan, B Maharjan, S Madhup, H D Shewade, A Abrahamyan, P Shah, S Shrestha, H Li, R Shrestha

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Abstract

Setting: Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu, Nepal.

Objectives: 1) To report the incidence of health-care-associated infections (HAIs), 2) to compare demographic, clinical characteristics and hospital outcomes in those with and without HAIs; and 3) to verify bacterial types in HAI and community-acquired infections (CAIs) among inpatients with invasive devices and/or surgical procedures.

Design: This was a cohort study using secondary data (December 2017 to April 2018).

Results: Of 1,310 inpatients, 908 (69.3%) had surgical procedures, 125 (9.5%) had invasive devices and 277 (21.1%) both. Sixty-six developed HAIs (incidence = 5/100 patient admissions, 95% CI 3.9-6.3). Individuals with HAIs had a 5.5-fold higher risk of longer hospital stays (⩾7 days) and a 6.9-fold risk of being in intensive care compared to the surgical ward. Unfavourable hospital exit outcomes were higher in those with HAIs (4.5%) than in those without (0.9%, P = 0.02). The most common HAI bacteria (n = 70) were Escherichia coli (44.3%), Enterococcus spp. (22.9%) and Klebsiella spp. (11.4%). Of 98 CAIs with 41 isolates, E. coli (36.6%), Staphylococcus aureus (22.0%) and methicillin-resistant S. aureus (14.6%) were common.

Conclusion: We found relatively low incidence of HAIs, which reflects good infection prevention and control standards. This study serves as a baseline for future monitoring and action.

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尼泊尔侵入性设备和外科手术中与医疗保健相关的感染发生率。

地点：尼泊尔加德满都加德满都大学医院 Dhulikhel 医院尼泊尔加德满都加德满都大学医院 Dhulikhel 医院：1）报告医疗相关感染（HAIs）的发生率；2）比较有HAIs和无HAIs患者的人口统计学、临床特征和住院结果；3）验证有侵入性设备和/或外科手术的住院患者中HAI和社区获得性感染（CAIs）的细菌类型：这是一项使用二手数据（2017 年 12 月至 2018 年 4 月）进行的队列研究：在1310名住院患者中，908人（69.3%）进行了外科手术，125人（9.5%）使用了侵入性设备，277人（21.1%）同时使用了侵入性设备和/或外科手术。其中 66 人发生了 HAI（发生率 = 5/100，95% CI 3.9-6.3）。与外科病房相比，发生 HAI 的患者住院时间延长（⩾7 天）的风险高出 5.5 倍，入住重症监护室的风险高出 6.9 倍。出现 HAI 的患者（4.5%）的出院不良后果高于未出现 HAI 的患者（0.9%，P = 0.02）。最常见的 HAI 细菌（n = 70）为大肠埃希菌（44.3%）、肠球菌属（22.9%）和克雷伯菌属（11.4%）。在 98 例 CAI 中的 41 个分离株中，大肠杆菌（36.6%）、金黄色葡萄球菌（22.0%）和耐甲氧西林金黄色葡萄球菌（14.6%）很常见：我们发现 HAIs 的发生率相对较低，这反映了良好的感染预防和控制标准。这项研究为今后的监测和行动提供了基线。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.