Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2020 Apr 24;15(4):e0231949. doi: 10.1371/journal.pone.0231949. eCollection 2020.
Hospital-Acquired Infections (HAIs) are acquired when the patient is hospitalized for more than 48 hours. In Ethiopia data are scarce in management appropriateness of HAIs. Hence, this study was aimed to assess the prevalence and management of HAIs among patients admitted at Zewditu Memorial Hospital.
A facility based prospective cross sectional study was conducted from March 1, 2017 to August 30, 2017. The sample was proportionally allocated among (medical, pediatrics, gynecology and obstetrics and surgical) wards, based on patient flow. Data were collected using data abstraction format and supplemented by key informant interview. Interview was made on eight physicians and four microbiologists who have been working in the wards during study period. Management appropriateness was assessed using Infectious Disease Society of America guideline and experts opinion (Infectious disease specialist). A multivariate logistic regression was used to identify factors associated with HAIs.
The prevalence of HAIs was 19.8%. Surgical Site Infection (SSI) and pneumonia accounted for 20 (24.7%) of the infections. Culture and sensitivity was done for 24 (29.6%) patients. Of the 81 patients who developed HAIs, 54 (66.67%) of them were treated inappropriately. Physicians' response for this variation was information gap, forgetfulness, affordability and availability issue of first line medications. Younger age (AOR (Adjusted odds ratio) = 8.53, 95% CI: 2.67-27.30); male gender (AOR = 2.06, 95% CI: 1.01-4.22); longer hospital stay (AOR = 0.17, 95% CI: 0.06-0.51); and previous hospital admission (AOR = 3.22, 95% CI: 1.76-5.89); were independent predictors of HAIs.
Prevalence of HAIs and inappropriate management were substantially high in this study. Pneumonia and SSI were the common types of HAIs. Locally conformable guidelines could help to correct such problems.
当患者住院时间超过 48 小时时，就会发生医院获得性感染（HAI）。在埃塞俄比亚，关于 HAI 的管理适宜性的数据很少。因此，本研究旨在评估在泽维图纪念医院住院的患者中 HAI 的患病率和管理情况。
本研究是一项基于医疗机构的前瞻性横断面研究，于 2017 年 3 月 1 日至 2017 年 8 月 30 日进行。根据患者流量，按比例将样本分配到（内科、儿科、妇产科和外科）病房。数据收集采用数据提取格式，并辅以关键知情人访谈。访谈对象为在研究期间在病房工作的 8 名医生和 4 名微生物学家。采用美国传染病学会指南和专家意见（传染病专家）评估管理适宜性。采用多变量逻辑回归分析确定与 HAI 相关的因素。
HAI 的患病率为 19.8%。手术部位感染（SSI）和肺炎占感染的 20 例（24.7%）。对 24 例（29.6%）患者进行了培养和药敏试验。在 81 例发生 HAI 的患者中，有 54 例（66.67%）治疗不当。医生对这种差异的反应是信息差距、健忘、一线药物的可负担性和可得性问题。年龄较小（调整后的优势比（AOR）=8.53，95%CI：2.67-27.30）；男性（AOR=2.06，95%CI：1.01-4.22）；住院时间较长（AOR=0.17，95%CI：0.06-0.51）；和既往住院史（AOR=3.22，95%CI：1.76-5.89）是 HAI 的独立预测因素。
本研究中 HAI 的患病率和不适当管理都很高。肺炎和 SSI 是常见的 HAI 类型。符合当地情况的指南可以帮助纠正这些问题。
