Incidence, Pathogens and Resistance Patterns of Nosocomial Infections at a Rural Hospital in Gabon

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2014 Mar 6

PMID 24592922

Citations 28

Authors

Micha Scherbaum

Katrin Kosters

Raymund Egid Murbeth

Ulysse Ateba Ngoa

Peter Gottfried Kremsner

Bertrand Lell

Abraham Alabi

Affiliations

Soon will be listed here.

Abstract

Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambaréné, Gabon.

Methods: This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections.

Results: A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms.

Conclusion: The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

Citing Articles

Prevalence of nosocomial infections at the Centre Hospitalier Universitaire du Point G in Bamako, Mali.

Beye S, Maiga A, Cissoko Y, Guindo I, Dicko O, Maiga M Rev Mali Infect Microbiol. 2024; 19(1):45-49.

PMID: 39555245 PMC: 11567683.

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis.

Melariri H, Freercks R, van der Merwe E, Ten Ham-Baloyi W, Oyedele O, Murphy R EClinicalMedicine. 2024; 71:102571.

PMID: 38606166 PMC: 11007440. DOI: 10.1016/j.eclinm.2024.102571.

Prevalence, risk factors, and antimicrobial resistance of endemic healthcare-associated infections in Africa: a systematic review and meta-analysis.

Bunduki G, Masoamphambe E, Fox T, Musaya J, Musicha P, Feasey N BMC Infect Dis. 2024; 24(1):158.

PMID: 38302895 PMC: 10836007. DOI: 10.1186/s12879-024-09038-0.

Compromised Nutritional Status as a Risk Factor for the Incidence of Nosocomial Infections.

Gupta S, Lubree H, Sanghavi S Cureus. 2023; 15(10):e46502.

PMID: 37927704 PMC: 10624772. DOI: 10.7759/cureus.46502.

Molecular epidemiology of antimicrobial resistance in central africa: A systematic review.

Dikoumba A, Onanga R, Mangouka L, Boundenga L, Ngoungou E, Godreuil S Access Microbiol. 2023; 5(8).

PMID: 37691840 PMC: 10484317. DOI: 10.1099/acmi.0.000556.v5.

References

Rosenthal V, Maki D, Salomao R, Alvarez Moreno C, Mehta Y, Higuera F . Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med. 2006; 145(8):582-91. DOI: 10.7326/0003-4819-145-8-200610170-00007. View

Wenzel R . Health care-associated infections: major issues in the early years of the 21st century. Clin Infect Dis. 2007; 45 Suppl 1:S85-8. DOI: 10.1086/518136. View

Alabi A, Frielinghaus L, Kaba H, Kosters K, Huson M, Kahl B . Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa. BMC Infect Dis. 2013; 13:455. PMC: 3849904. DOI: 10.1186/1471-2334-13-455. View

. Safe surgery prevents infection. Lancet Infect Dis. 2009; 9(4):203. DOI: 10.1016/S1473-3099(09)70093-3. View

Obeng-Nkrumah N, Twum-Danso K, Krogfelt K, Newman M . High levels of extended-spectrum beta-lactamases in a major teaching hospital in Ghana: the need for regular monitoring and evaluation of antibiotic resistance. Am J Trop Med Hyg. 2013; 89(5):960-964. PMC: 3820343. DOI: 10.4269/ajtmh.12-0642. View

Okeke I, Laxminarayan R, Bhutta Z, Duse A, Jenkins P, OBrien T . Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis. 2005; 5(8):481-93. DOI: 10.1016/S1473-3099(05)70189-4. View

Bagheri Nejad S, Allegranzi B, Syed S, Ellis B, Pittet D . Health-care-associated infection in Africa: a systematic review. Bull World Health Organ. 2011; 89(10):757-65. PMC: 3209981. DOI: 10.2471/BLT.11.088179. View

Christenson M, Hitt J, Abbott G, Septimus E, Iversen N . Improving patient safety: resource availability and application for reducing the incidence of healthcare-associated infection. Infect Control Hosp Epidemiol. 2006; 27(3):245-51. DOI: 10.1086/500370. View

Fehr J, Hatz C, Soka I, Kibatala P, Urassa H, Smith T . Risk factors for surgical site infection in a Tanzanian district hospital: a challenge for the traditional National Nosocomial Infections Surveillance system index. Infect Control Hosp Epidemiol. 2006; 27(12):1401-4. DOI: 10.1086/509855. View

10.

Geffers C, Sohr D, Gastmeier P . Mortality attributable to hospital-acquired infections among surgical patients. Infect Control Hosp Epidemiol. 2008; 29(12):1167-70. DOI: 10.1086/592410. View

11.

Mawalla B, Mshana S, Chalya P, Imirzalioglu C, Mahalu W . Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011; 11:21. PMC: 3175437. DOI: 10.1186/1471-2482-11-21. View

12.

Simon F, Demortiere E, Chadli M, Kraemer P, De Pina J . [Risk of noscomial infection in intertropical Africa--part 1: background]. Med Trop (Mars). 2006; 66(1):91-6. View

13.

Woerther P, Angebault C, Jacquier H, Hugede H, Janssens A, Sayadi S . Massive increase, spread, and exchange of extended spectrum β-lactamase-encoding genes among intestinal Enterobacteriaceae in hospitalized children with severe acute malnutrition in Niger. Clin Infect Dis. 2011; 53(7):677-85. DOI: 10.1093/cid/cir522. View

14.

Burke J . Infection control - a problem for patient safety. N Engl J Med. 2003; 348(7):651-6. DOI: 10.1056/NEJMhpr020557. View

15.

Vlieghe E, Phoba M, Tamfun J, Jacobs J . Antibiotic resistance among bacterial pathogens in Central Africa: a review of the published literature between 1955 and 2008. Int J Antimicrob Agents. 2009; 34(4):295-303. DOI: 10.1016/j.ijantimicag.2009.04.015. View

16.

. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005; 171(4):388-416. DOI: 10.1164/rccm.200405-644ST. View

17.

Vincent J, Rello J, Marshall J, Silva E, Anzueto A, Martin C . International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009; 302(21):2323-9. DOI: 10.1001/jama.2009.1754. View

18.

Aranaz-Andres J, Aibar-Remon C, Vitaller-Murillo J, Ruiz-Lopez P, Limon-Ramirez R, Terol-Garcia E . Incidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events. J Epidemiol Community Health. 2008; 62(12):1022-9. DOI: 10.1136/jech.2007.065227. View

19.

Gedebou M, Kronvall G . Hospital-acquired infections among surgical patients in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Am J Infect Control. 1988; 16(1):7-13. DOI: 10.1016/0196-6553(88)90004-1. View

20.

Chastre J, Fagon J . Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002; 165(7):867-903. DOI: 10.1164/ajrccm.165.7.2105078. View