Prevalence of hospital-acquired infections and associated factors among patients admitted to Hawassa University Comprehensive Specialized Hospital, southern Ethiopia

Abstract

Background: Healthcare-associated infections (HAIs) are more prevalent in developing countries and impact worsened health outcome. Therefore, routine surveillance of infection is an important part of infection prevention and quality assurance in hospitals. The objective of this study was to determine the prevalence and associated factors of HAIs among inpatients in Hawassa University Comprehensive Specialized Hospital (HUCSH).

Methods: An institution-based cross-sectional study was used to determine the prevalence and associated factors of HAIs among 413 patients of all ages admitted to all inpatient wards and intensive care units (ICUs) of HUCSH from 28 June 2021 to 23 August 2021. All admitted patients with three days of inpatient stay on the day of survey were eligible for the study. Data were collected by five trained nurses from patients’ medical records using an observational checklist. The Environmental factors were assessed with two environmental health professionals. Coded and cleaned data from EpiData version 3.5 were transferred to IBM SPSS version 23 for analysis. Univariate and multivariable logistic regression analyses were used to determine the prevalence of HAIs and determinant factors, respectively.

Results: A total of 413 patients were included in this survey. The median age of the participants was 26 years (interquartile range: 3 month to 80 years). A total of 352 (85.2%) patients were diagnosed with non-fatal disease during the survey. There were 49 patients with HAI with a prevalence of 11.9 %. Coagulate negative staphylococcus (27.27 %), and E. coli (27.27%) were the most frequently reported pathogens from the result of culture. Patients admitted with rapidly fatal disease (adjusted odds ratio [AOR] =3.689) and ultimately fatal disease (AOR=3.791), length of hospital stay (AOR=2.056) and absence of running tap water at patient’s room (AOR=3.49) were statistically significant factors associated with the occurrence of HAIs.

Conclusion: Surgical site infections and blood stream infections constituted the highest proportion of HAIs. Besides,  the proportion of HAIs among wards indicated a large variability. Consequently, severity of underlying medical conditions such as admission with rapidly fatal disease, admission with ultimately fatal disease, length of hospital stay for more than five days, and absence of hand washing facilities were the three independent predictors of HAI. Therefore, Hospital management and health care workers (HCWs) should give more attention on the severity of admission diagnosis and the practice of hand washing protocol in order to achieve a reduced prevalence of HAIs.