Patterns and outcomes of health-care associated infections in the medical wards at Bugando medical centre: a longitudinal cohort study

Maliha I Kassam; Vitus Silago; Prisca Damiano; Bahati Wajanga; Jeremiah Seni; Stephen E Mshana; Samuel Kalluvya

doi:10.1186/s13756-023-01345-6

Patterns and outcomes of health-care associated infections in the medical wards at Bugando medical centre: a longitudinal cohort study

Antimicrob Resist Infect Control. 2023 Dec 5;12(1):139. doi: 10.1186/s13756-023-01345-6.

Authors

Maliha I Kassam^{1

2}, Vitus Silago³, Prisca Damiano⁴, Bahati Wajanga^{1

2}, Jeremiah Seni⁴, Stephen E Mshana⁴, Samuel Kalluvya^{1

2}

Affiliations

¹ Department of Internal Medicine, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania.
² Department of Internal Medicine, Bugando Medical Center, P. O. Box 1370, Mwanza, Tanzania.
³ Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania. [email protected].
⁴ Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania.

Abstract

Background: The burden of healthcare associated infections (HCAIs) in low- and middle-income countries (LMICs) remains underestimated due to diagnostic complexity and lack of quality surveillance systems. We designed this study to determine clinical diagnosis, laboratory-confirmed, associated factors and risks of HCAIs.

Methods: This hospital-based longitudinal cohort study was conducted between March and June 2022 among adults (≥ 18 years) admitted in medical wards at BMC in Mwanza, Tanzania. Patients who were negative for HCAIs by clinical evaluations and laboratory investigations during admission were enrolled and followed-up until discharge or death. Clinical samples were collected from patients with clinical diagnosis of HCAIs for conventional culture and antimicrobial sensitivity testing.

Results: A total of 350 adult patients with a median [IQR] age of 54 [38-68] years were enrolled in the study. Males accounted for 54.6% (n = 191). The prevalence of clinically diagnosed HCAIs was 8.6% (30/350) of which 26.7% (8/30) had laboratory-confirmed HCAIs by a positive culture. Central-line-associated bloodstream infection (43.3%; 13/30) and catheter-associated urinary tract infection (36.7%; 11/30) were the most common HCAIs. Older age was the only factor associated with development of HCAIs [mean (± SD); [95%CI]: 58.9(± 12.5); [54.2-63.5] vs. 51.5(± 19.1); [49.4-53.6] years; p = 0.0391) and HCAIs increased the length of hospital stay [mean (± SD); [95%CI]: 13.8 (± 3.4); [12.5-15.1] vs. 4.5 (± 1.7); [4.3-4.7] days; p < 0.0001].

Conclusion: We observed a low prevalence of HCAIs among adult patients admitted to medical wards in our setting. Central-line-associated bloodstream infections and catheter-associated urinary tract infections are common HCAIs. Significantly, older patients are at higher risk of acquiring HCAIs as well as patients with HCAIs had long duration of hospital stays.

Keywords: Catheter-associated urinary tract Infection; Central-line-associated bloodstream Infection; Healthcare-associated Infections; Inpatients; Medical wards.

MeSH terms

Adult
Aged
Cohort Studies
Cross Infection* / epidemiology
Hospitals
Humans
Longitudinal Studies
Male
Middle Aged
Tanzania / epidemiology