Hospital acquired infections among surgical, gynaecology and obstetrics patients in Felege-Hiwot referral hospital, Bahir Dar, northwest Ethiopia.

BACKGROUND: Hospital-acquired infection is an important public health problem that contributes to significant morbidity and mortality worldwide. OBJECTIVE: The aim of this study was to assess the prevalence and risk factors of hospital-acquired infections and the antibiotic susceptibility pattern of bacterial isolates in Felege-Hiwot referral hospital. METHODS: The study was conducted during April-August 2009. A total of 1383 patients admitted to Surgical and Gynecology/Obstetrics wards were followed throughout their stay in the hospital for development of infections. Data on sociodemographic, underlying diseases and risk factors were collected and analysed Laboratory investigations including culture, biochemical tests, Gram staining and antibacterial sensitivity tests using disc diffusion methods were done. RESULTS: Of the 1383 patients assessed 961 surgical, 333 obstetrics and 89 gynaecology patients assessed, 17.1% 21.0% and 13.5% developed infections, respectively. The over all incidence of hospital acquired infections was 246 (17.8%) with 251 (18.1%) episodes of bacterial infections. Urinary tract and surgical site infections were detected in 118 (48%) and 112 (45.6%) of the cases, respectively. Of the bacterial isolates, 132 (52.6%) were gram negative and 119 (47.4%) gram positive. Escherichia coli, Klebsiella pneumoniae, Psuedomonas aeruginosa, were the dominant gram negative isolates accounting for 49 (19.5%), 36 (14.3%) and 26 (10.4%), respectively. On the other hand, Staphylococcus aureus, coagulase negative staphylococci, and Enteroccocus species were isolated in 91 (36.3%), 18 (7.2%) and 10 (4.0%), respectively. Surgery, catheterization, underlying diseases, antibiotics prophylaxis and length of hospital stay were risk factors for infection (P<0.0001). Most, >80% of isolates showed high rate of resistance to ampicillin, chloramphenicol, and amoxacillin-clavulanic acid CONCLUSION: The incidence of surgical site infection in surgical and UTI in obstetrics patients was high. Escherichia coli from urinary tract infection and Staphylococcus aureus from surgical wounds were predominant isolates. The isolates showed high resistance to common antibiotics.

Postoperative Nosocomial Infections and Antimicrobial Resistance Pattern of Bacteria Isolates among Patients Admitted at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia.

BACKGROUND: Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections and determine their current antimicrobial resistance to commonly prescribed drugs. METHODS: A cross sectional study was conducted on patients under gone operation from October 2010 to January 2011 and followed for development of clinical signs and symptoms of surgical site and blood stream infection until the time of discharge. Structured questionnaire was used to collect socio demographic characteristics. Wound swab and venous blood samples were collected and processed for bacterial isolation and antimicrobial susceptibility testing following standard bacteriological techniques. RESULTS: Out of 294 patients who had clean and clean-contaminated operation, 10.9% were confirmed of bacterial nosocomial infections. The rate of nosocomial infections among clean and clean-contaminated operations was 3.3% and 12.8% respectively. Nosocomial surgical site and blood stream infection rate was 10.2% and 2.4% correspondingly. A total of 42 bacterial pathogens were identified of which S. aureus was the leading isolates accounting 26.2% followed by E. coli and Coagulase negative Staphylococcus species each 21.4%. Nearly 100% of Gram positive and 95.5% of Gram negative bacterial isolates showed resistance against two or more antimicrobial drugs. CONCLUSIONS: Multiple drug resistance of isolates to antimicrobials was alarmingly high so that any empirical prophylaxis and treatment needs careful selection of effective drugs. To minimize such infections, adherence of strict aseptic surgical procedures and proper management of wounds is required.