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Badger-Emeka L, Al Rashed AS, Aljindan RY, Emeka PM, Quadri SA, Almutairi HH. Incidence of Drug-Resistant Hospital-Associated Gram-Negative Bacterial Infections, the Accompanying Risk Factors, and Clinical Outcomes with Treatment. Antibiotics (Basel) 2023; 12:1425. [PMID: 37760721 PMCID: PMC10525819 DOI: 10.3390/antibiotics12091425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Extensive drug resistance to bacterial infections in hospitalised patients is accompanied by high morbidity and mortality rates due to limited treatment options. This study investigated the clinical outcomes of single and combined antibiotic therapies in extensive (XDR), multidrug-resistant (MDR) and susceptible strains (SS) of hospital-acquired infections (HAIs). Cases of hospital-associated drug-resistant infections (HADRIs) and a few susceptible strains from hospital wards were selected for this study. Bacteria identifications (IDs) and antimicrobial susceptibility tests (ASTs) were performed with a Vitek 2 Compact Automated System. Patients' treatment types and clinical outcomes were classified as alive improved (AI), alive not improved (ANI), or died. The length of hospital stay (LOHS) was acquired from hospital records. The HAI pathogens were Acinetobacter baumannii (28%), Escherichia coli (26%), Klebsiella pneumoniae (22%), Klebsiella (2%) species, Pseudomonas aeruginosa (12%), Proteus mirabilis (4%), and other Enterobacteriaceae. They were MDR (40.59%), XDR (24.75%), carbapenem-resistant Enterobacteriaceae (CRE, 21.78%) and susceptible (12%) strains. The treatments were either monotherapy or combined therapy with different outcomes. Monotherapy produced positive significant outcomes with E. coli infections, while for P. aeruginosa, there were no differences between the number of infections treated with either mono/combined therapies (50% each). Nonetheless, combined therapy had significant effects (p < 0.05) as a treatment for A. baumannii and K. pneumoniae infections. Clinical outcomes and LOHS varied with infecting bacteria. The prevalence of XDR and MDR HAIs was found to be significantly high, with no association with treatment type, LOHS, or outcome.
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Affiliation(s)
- Lorina Badger-Emeka
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Abdullatif S. Al Rashed
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.S.A.R.)
| | - Reem Y. Aljindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.S.A.R.)
| | - Promise Madu Emeka
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Sayed A. Quadri
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Hayfa Habes Almutairi
- Department of Chemistry, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Abiodun A, Adekanye A, Nwachukwu C, Ayanbeku T, Abiodun J. MICROBACTERIAL PROFILE OF SURGICAL SITE INFECTION AND THEIR PATTERN OF SENSITIVITY IN TERTIARY HOSPITAL IN NORTH CENTRAL HOSPITAL, NIGERIA. Ann Ib Postgrad Med 2023; 21:30-35. [PMID: 38298347 PMCID: PMC10811704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/30/2023] [Indexed: 02/02/2024] Open
Abstract
Background Surgical site infections (SSI) remain a problem in surgical practice despite the improvement in advanced technology and the use of antibiotics. Also, there is also a growing menace of antibiotic resistance which poses a great challenge in treating SSI. The study aimed to find out the most common bacterial pathogens responsible for surgical site infection and their antibiotic sensitivity profile. Material and Methods It was a descriptive study carried out in Federal Medical Centre, Bida. 500 surgical procedures were carried out and samples were obtained from 73 patients that showed clinical evidence of SSI for culture and susceptibility test. Samples were collected from each patient using a swab stick. Bacteriological culture examination and identification were done following standard microbiological techniques. Susceptibility testing was performed by Kirby-Bauer technique according to Clinical and Laboratory Standards institute 26th edition. Data were analysed using SPSS 26. Results Out of the 73 samples taken, 83 isolates were obtained while five samples yielded no growth. Gram-negative bacteria (GNB) were predominant in 73(88.1%) with the dominant being E. Coli species (38.6%). From the strains that were isolated, there were 9(10.8%) Staph aureus was the only Gram-positive organism. Concerning antibiotic susceptibility, the results demonstrated remarkably high multidrug resistance. However, the meropenems and amikacin demonstrated good activities against all gram-negative isolates. The resistance pattern of enterobacteriaceae to tested antibiotics were to ciprofloxacin (90.2%) levofloxacin (82.2%) augmentin (88.5%) ceftriaxone (85.2%) ceftazidime (80.3%), gentamicin (80.3%) meropenems (14.8%) amikacin (16.4%.). Conclusion The study demonstrated a high alarming rate of multidrug resistance following SSI and this should call for concerns and surveillance among surgeons.
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Affiliation(s)
- A.A. Abiodun
- Department of Surgery, Federal Medical Centre, Bida
| | | | - C.N.D. Nwachukwu
- Department of Obstretrics and Gyneacology, Federal Medical Centre, Bida
| | - T.S. Ayanbeku
- Department of Microbiology, Federal Medical Centre, Bida
| | - J.A. Abiodun
- Department of Community Health, Federal Medical Centre, Bida
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Ataiyero Y, Dyson J, Graham M. The barriers and facilitators to hand hygiene practices in Nigeria: A qualitative study: "There are so many barriers ... the barriers are limitless.". Am J Infect Control 2023; 51:295-303. [PMID: 36804099 DOI: 10.1016/j.ajic.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 02/18/2023]
Abstract
BACKGROUND Health care associated infections (HCAIs) are a global challenge and hand hygiene is the primary measure to reduce these. In developing countries, patients are between 2 and 20 times more likely to acquire an HCAI compared with developed countries. Estimates of hand hygiene in Sub-Saharan Africa suggests 21% concordance. There are few studies investigating barriers and facilitators and those published tend to be surveys. This study aimed to understand barriers and facilitators to hand hygiene in a hospital in Nigeria. METHODS A theoretically underpinned in-depth qualitative interview study with thematic analysis of nurses and doctors working in surgical wards. RESULTS There were individual and institutional factors constituting barriers or facilitators: (1) knowledge, skills, and education, (2) perceived risks of infection to self and others, (3) memory, (4) the influence of others and (5) skin irritation. Institutional factors were (1) environment and resources and (2) workload and staffing levels. CONCLUSIONS Our study presents barriers and facilitators not previously reported and offers nuances and detail to those already reported in the literature. Although the primary recommendation is adequate resources, however small local changes such as gentle soap, simple skills and reminder posters and mentorship or support could address many of the barriers listed.
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Affiliation(s)
- Yetunde Ataiyero
- School of Nursing and Midwifery, University of Hull, Hull, United Kingdom.
| | - Judith Dyson
- Centre for Social Care, Health and Related Research, Birmingham City University, Birmingham, United Kingdom
| | - Moira Graham
- School of Nursing and Midwifery, University of Hull, Hull, United Kingdom
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Ataiyero Y, Dyson J, Graham M. An observational study of hand hygiene compliance of surgical healthcare workers in a Nigerian teaching hospital. J Infect Prev 2022; 23:59-66. [PMID: 35340923 PMCID: PMC8941592 DOI: 10.1177/17571774211066774] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background Patients sometimes contract healthcare associated infections (HCAI) which are unrelated to their primary reasons for hospital admission. Surgical site infections are the most investigated and most recurrent type of HCAI in developing countries, affecting up to one-third of surgical patients. Objective This study aimed to assess and offer context to the hand hygiene resources available in a Nigerian teaching hospital through ward infrastructure survey, and to determine the hand hygiene compliance rate among surgical healthcare workers (HCWs) in a Nigerian teaching hospital through hand hygiene observations. Methods Ward infrastructure survey was conducted in the two adult surgical wards of the hospital using the World Health Organisation (WHO) hand hygiene ward infrastructure survey form. Hand hygiene observations were monitored over seven days in the surgical wards using a modified WHO hand hygiene observation form. Results Hand hygiene resources were insufficient, below the WHO recommended minimum standards. Seven hundred hand hygiene opportunities were captured. Using SPSS version 24.0, we conducted a descriptive analysis of audit results, and results were presented according to professional group, seniority and hand hygiene opportunities of the participants. Overall hand hygiene compliance was 29.1% and compliance was less than 40% across the three professional groups of doctors, nurses and healthcare assistants. Conclusion Hand hygiene compliance rates of the surgical HCWs are comparable to those in other Sub-Saharan African countries as well as in developed countries.
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Affiliation(s)
- Yetunde Ataiyero
- School of Health, Science and Wellbeing,
Staffordshire University, Stafford, UK,Yetunde Ataiyero, School of Health, Science and
Wellbeing, Staffordshire University, Stafford, UK
| | - Judith Dyson
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Moira Graham
- Faculty of Health Sciences, University of Hull, Hull, UK
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Abubakar U. Point-prevalence survey of hospital acquired infections in three acute care hospitals in Northern Nigeria. Antimicrob Resist Infect Control 2020; 9:63. [PMID: 32393348 PMCID: PMC7216694 DOI: 10.1186/s13756-020-00722-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 04/23/2020] [Indexed: 11/12/2022] Open
Abstract
Background Effective infection prevention and control strategies require reliable data describing the epidemiology of hospital acquired infections (HAIs), and this is currently lacking in Nigeria. The objective of this study was to evaluate the prevalence, types and risk factors associated with HAIs in acute care hospitals in Northern Nigeria. Methods A pilot point-prevalence survey was conducted in three acute care hospitals in Northern Nigeria between April and May 2019 using a protocol developed by the European Centre for Disease Prevention and Control. Patients admitted into the wards at or before 8.00 am on the survey date were included. Patients’ medical records were reviewed by a clinical pharmacist with the support of the attending physician and nurse to identify HAIs. Results Of the 321 patients surveyed, 50 HAIs were identified among 46 patients translating into a point-prevalence of 14.3%. The most common HAIs were bloodstream infection (38.0%), surgical site infections (32.0%) and pneumonia (12.0%). Neonatal (53.0%), pediatric surgical (26.7%) and surgical (10.1%) specialties had the highest prevalence. Device associated infections represented 16% of all HAIs including bloodstream infections and pneumonia. Of all the HAIs, 15 (30.0%) were present at the time of admission while 75.5% originated from the current hospitals. Univariate analysis showed that newborn (less than 1 month old) (OR: 4.687 95% CI: 1.298–16.927), intubation (OR: 3.966, 95% CI: 1.698–9.261), and neonatal (OR: 41.538 95% CI: 4.980–346.5) and pediatric surgical (OR: 13.091 95% CI: 1.532–111.874) specialties were significantly associated with HAI. Conclusion The prevalence of HAI was relatively high compared to other developing countries and was significantly associated with neonatal and pediatric surgical specialties. Hospital infection control strategies should be strengthened to reduce the burden of HAIs.
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Affiliation(s)
- Usman Abubakar
- Pharmacy Department, Ibrahim Badamasi Babangida (IBB) Specialist Hospital, Minna, Niger State, Nigeria.
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Nwosu ADG, Onyekwulu FA, Aniwada EC. Patient safety awareness among 309 surgeons in Enugu, Nigeria: a cross-sectional survey. Patient Saf Surg 2019; 13:33. [PMID: 31673290 PMCID: PMC6814998 DOI: 10.1186/s13037-019-0216-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/10/2019] [Indexed: 02/07/2023] Open
Abstract
Background Adverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcome; thus we set out to appraise the patient safety awareness among surgeons in Enugu, Nigeria. Methods A multi-institutional cross-sectional survey was carried out among surgeons in Enugu, Nigeria and data obtained were analyzed using the statistical package for scientific solutions (SPSS) version 20 software. Results A total of 309 surgeons were surveyed. Majority of the surgeons (51.9%) had poor perception of patient safety issues. One hundred and twenty respondents (38.8%) have awareness of any institutional protocol for preventing wrong-site surgery while only 35 respondents (11.3%) regularly practiced an institutional protocol for preventing wrong-site surgery. The professional status of the surgeons and years in service showed significant association with perception of patient safety issues. Conclusion The patient safety awareness and practice among the surgeons in Enugu, Nigeria is apparently low and this was found to be influenced by the professional status and years in service of the surgeon.
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Affiliation(s)
| | | | - Elias Chikee Aniwada
- 3Department of Community Medicine, College Of Medicine, University Of Nigeria, Nsukka, Nigeria
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Dayyab FM, Iliyasu G, Aminu A, Habib ZG, Tiamiyu AB, Tambuwal SH, Borodo MM, Habib AG. A prospective study of hospital-acquired infections among adults in a tertiary hospital in north-western Nigeria. Trans R Soc Trop Med Hyg 2019. [PMID: 29538772 DOI: 10.1093/trstmh/try020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Hospital-acquired infections (HAIs) are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes and microbiological profile of HAIs. Methods This prospective study was carried out on patients identified to have developed HAIs while admitted to the medical wards, surgical wards, dialysis unit and intensive care unit (ICU) of the hospital. Patients were recruited consecutively until the target study population was reached. A clinical evaluation and relevant laboratory investigations were carried out. Results A total of 100 patients who had 144 episodes of HAIs were studied. Rates of HAIs were 7.16%, 18.63% and 1.75% in the medical wards, ICU and surgical wards, respectively. The most common HAI was urinary tract infection caused by Escherichia coli. High-level resistance to commonly prescribed antibiotics, especially ampicillin and ceftriaxone, was observed among causative bacteria. Conclusion The burden of HAIs is high and similar to other parts of Nigeria. There is a need for continued surveillance of HAIs in all the wards of the hospital in order to fully describe the extent of the problem.
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Affiliation(s)
- Farouq Muhammad Dayyab
- Infectious and Tropical Diseases Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Garba Iliyasu
- Infectious and Tropical Diseases Unit, Department of Medicine, College of Health Sciences, Bayero University Kano, Nigeria
| | - Aliyu Aminu
- Department of Medical Microbiology and Parasitology, Aminu Kano Teaching Hospital, Nigeria
| | - Zaiyad Garba Habib
- Infectious and Tropical Diseases Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Abdulwasiu Bolaji Tiamiyu
- Infectious and Tropical Diseases Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Sirajo Haliru Tambuwal
- Infectious and Tropical Diseases Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Muhammad Musa Borodo
- Department of Medicine, College of Health Sciences, Bayero University Kano, Nigeria
| | - Abdulrazaq Garba Habib
- Infectious and Tropical Diseases Unit, Department of Medicine, College of Health Sciences, Bayero University Kano, Nigeria
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Abubakar U, Syed Sulaiman SA, Adesiyun AG. Impact of pharmacist-led antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis in obstetric and gynecologic surgeries in Nigeria. PLoS One 2019; 14:e0213395. [PMID: 30845240 PMCID: PMC6405127 DOI: 10.1371/journal.pone.0213395] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/19/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Inappropriate and excessive use of surgical antibiotic prophylaxis are associated with the emergence of antibiotic resistance. Antibiotic prophylaxis malpractices are common in obstetrics and gynecology settings and antibiotic stewardship is used to correct such malpractice. OBJECTIVE To evaluate the impact of antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis practice in obstetrics and gynecology surgeries. METHOD A prospective pre- and post-intervention study was conducted in two tertiary hospitals between May and December 2016. The duration of the each period was 3 months. Antibiotic stewardship interventions including development of a protocol, educational meeting and audit and feedback were implemented. Data were collected using the patient records and analyzed with SPSS version 23. RESULTS A total of 226 and 238 surgical procedures were included in the pre- and post-intervention periods respectively. Age, length of stay and estimated blood loss were similar between the two groups. However, specialty and surgical procedures varied significantly. There was a significant increase in compliance with timing (from 14.2% to 43.3%) and duration (from 0% to 21.8%) of surgical antibiotic prophylaxis after the interventions. The interventions significantly reduced the prescription of third generation cephalosporin (-8.6%), redundant antibiotic (-19.1%), antibiotic utilization (-3.8 DDD/procedure) and cost of antibiotic prophylaxis (-$4.2/procedure). There was no significant difference in the rate of surgical site infection between the two periods. Post-intervention group (OR: 5.60; 95% CI: 3.31-9.47), elective surgery (OR: 4.62; 95% CI: 2.51-8.47) and hospital attended (OR: 9.89; 95% CI: 5.66-17.26) were significant predictors of compliance with timing while elective surgery (OR: 12.49; 95% CI: 2.85-54.71) and compliance with timing (OR: 58.55; 95% CI: 12.66-270.75) were significantly associated with compliance to duration of surgical antibiotic prophylaxis. CONCLUSION The interventions improve compliance with surgical antibiotic prophylaxis and reduce antibiotic utilization and cost. However, there is opportunity for further improvement, particularly in non-elective surgical procedures.
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Affiliation(s)
- Usman Abubakar
- Pharmacy Department, Ibrahim Badamasi Babangida Specialist Hospital, Minna, Nigeria
| | - Syed Azhar Syed Sulaiman
- Department of clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Adebiyi Gbadebo Adesiyun
- Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Feleke T, Eshetie S, Dagnew M, Endris M, Abebe W, Tiruneh M, Moges F. Multidrug-resistant bacterial isolates from patients suspected of nosocomial infections at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. BMC Res Notes 2018; 11:602. [PMID: 30126447 PMCID: PMC6102927 DOI: 10.1186/s13104-018-3709-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/14/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives As the hospital environment favors the circulation of drug resistant bacteria, continuous surveillance of antibiotic resistant patterns is an important approach for a better patient management. This study is therefore, aimed to assess multidrug resistant bacterial isolates from patients suspected of nosocomial infections at the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. Results Of the 260 patients, 173 (66.5%) of them were culture positive. Among culture positive patients a total of 216 bacterial isolates were recovered, of which the most common species were S. aureus 77 (35.6%), followed by E. coli 33 (15.3%) and Klebsiella spp 29 (13.4%). Of the S. aureus isolates, 67.5% were cefoxitin (methicillin) resistant. Citrobacter spp (100%), Klebsiella spp (79.3%) and E. coli (75.3%) were the leading MDR Gram-negative isolates. The overall MDR resistant rate was 152 (70.4%).
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Affiliation(s)
- Tigist Feleke
- Department of Hospital Laboratory, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia.
| | - Setegn Eshetie
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulat Dagnew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistu Endris
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwossen Abebe
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Tiruneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Laboratory-confirmed hospital-acquired infections: An analysis of a hospital's surveillance data in Nigeria. Heliyon 2018; 4:e00720. [PMID: 30094385 PMCID: PMC6072901 DOI: 10.1016/j.heliyon.2018.e00720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/05/2018] [Accepted: 07/31/2018] [Indexed: 12/29/2022] Open
Abstract
Objective Hospital-acquired infections (HAI) are a global problem and a major public health concern in hospitals throughout the world. Quantification of HAI is needed in developing countries; hence we describe the results of a 2-year surveillance data in a tertiary hospital in Nigeria. Methodology This study is a 2-year review using secondary data collected at a tertiary referral center in northwestern Nigeria. The data was collected using surveillance forms modeled based on the Centre for Disease Control (CDC) protocol. Descriptive statistics were used to present results as frequencies and percentages. Result 518 patients developed HAI out of 8216 patients giving an overall prevalence of 6.3%. The mean age of the patients was 35.98 years (±15.92). Males constituted 281 (54.2%). UTI 223 (43.1%) was the most prevalent HAI. Overall, E. coli 207 (40.0%) was the most frequent isolates followed by P. aerugenosa 80 (15.4%). There was a high prevalence of cloxacillin resistant S. aureus (67.9%) and gram-negative rods resistant to third-generation cephalosporins. Trimethoprim-sulfamethoxazole resistance across the board was more than 90%. Conclusion There is a high burden of HAI especially UTI in our hospital with resistance to commonly used antibiotics documented.
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Olowo-Okere A, Ibrahim YKE, Sani AS, Olayinka BO. Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study. Med Sci (Basel) 2018; 6:E60. [PMID: 30061516 PMCID: PMC6163208 DOI: 10.3390/medsci6030060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/31/2022] Open
Abstract
Surgical site infection (SSI) is one of the most frequent complications of surgical interventions. Several factors have been identified as major determinants of occurrence of SSIs. The present study determined the occurrence and possible risk factors associated with SSIs at a tertiary healthcare facility in Abuja, Nigeria. All patients scheduled for operation in the hospital during the study period and who consented to participate willingly in the study were observed prospectively for the occurrence of SSI based on criteria stipulated by the United States Centre for Disease Control and Prevention (CDC). Data on sociodemographic characteristics, lifestyle, surgical procedure and co-morbidity were collected into a pre-tested data collection tool and analysed using IBM SPSS Statistics software v.24. Predictors of SSIs were identified using multivariate logistic regression model and p-value less than 0.05 was considered statistically significant. Of the 127 surgical patients that met the inclusion criteria comprising 65 (51.2%) females and 62 (48.8%) males between 1 and 83 years with mean age of 25.64 ± 1.66 years, 35 (27.56%; 95% Confidence Interval (CI): 0.205⁻0.360) developed SSIs. Prolonged post-operative hospital stays (p < 0.05), class of wound (p < 0.0001) and some comorbid conditions were found to be significantly associated with higher SSI rate. The SSI rate was highest among patients that had Kirschner-wire insertion (75.0%), followed by an unexpectedly high infection rate among patients that had mastectomy (42.9%), while lower percentages (33.3%) were recorded among patients that had exploratory laparotomy and appendicectomy. The overall magnitude of SSIs in this facility is high (27.6%; 95% CI: 0.205⁻0.360). Several factors were found to be independent predictors of occurrence of SSI. The findings thus highlight the need for improved surveillance of SSIs and review of infection control policies of the hospital.
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Affiliation(s)
- Ahmed Olowo-Okere
- Department of Pharmaceutics and Pharmaceutical Microbiology, Usmanu Danfodiyo University, Sokoto 840, Nigeria.
| | | | - Ali Samuel Sani
- Department of Surgery, University of Abuja Teaching Hospital, Gwagwalada, FCT-Abuja 902, Nigeria.
| | - Busayo Olalekan Olayinka
- Department of Pharmaceutics and Pharmaceutical Microbiology, Ahmadu Bello University, Zaria 810, Nigeria.
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Abubakar U, Syed Sulaiman SA, Adesiyun AG. Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria. Int J Clin Pharm 2018; 40:1037-1043. [DOI: 10.1007/s11096-018-0702-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/20/2018] [Indexed: 12/25/2022]
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Ali S, Birhane M, Bekele S, Kibru G, Teshager L, Yilma Y, Ahmed Y, Fentahun N, Assefa H, Gashaw M, Gudina EK. Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study. Antimicrob Resist Infect Control 2018; 7:2. [PMID: 29312659 PMCID: PMC5755436 DOI: 10.1186/s13756-017-0298-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 12/29/2017] [Indexed: 11/21/2022] Open
Abstract
Background Healthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described. Methods Longitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection. The specimens were processed by standard microbiological methods to isolate and identify bacteria etiology. Clinical and laboratory data were collected using structured case report formats. Results The incidence rate of hospital acquired infection was 28.15 [95% C.I:24.40,32.30] per 1000 patient days while the overall prevalence was 19.41% (95% C.I: (16.97–21.85). The highest incidence of HAI was seen in intensive care unit [207.55 (95% C.I:133.40,309.1) per 1000 patient days] and the lowest incidence was reported from ophthalmology ward [0.98 (95% C.I: 0.05,4.90) per 1000patient days]. Among patients who underwent surgical procedure, the risk of HAI was found to be high in those with history of previous hospitalization (ARR = 1.65, 95% C.I:1.07, 2.54). On the other hand, young adults (18 to 30-year-old) had lower risk of developing HAI (ARR = 0.54 95% C.I: 0.32,0.93) Likewise, among non-surgical care groups, the risk of HAI was found to be high in patients with chest tube (ARR = 4.14, 95% C.I: 2.30,7.46), on mechanical ventilation (ARR = 1.99, 95% C.I: 1.06,3.74) and with underlying disease (ARR = 2.01, 95% C.I: 1.33,3.04). Furthermore, hospital aquired infection at the hosoital was associated with prolonged hospital stay [6.3 more days, 95% C.I: (5.16,7.48), t = 0.000] and increased in hospital mortality (AOR, 2.23, 95% CI:1.15,4.29). Conclusion This study revealed high burden and poor discharge outcomes of healthcare associated infection at Jimma University Medical Centre. There is a difference in risk factors between patients with and without surgery. Hence, any effort to control the observed high burden of HAI at the hospital should consider these differences for better positive out put. Electronic supplementary material The online version of this article (10.1186/s13756-017-0298-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Solomon Ali
- School of Medical laboratory Science, Institute of Health, School of Medical laboratory Science, Jimma University, P.O. Box 1368, Jimma, Ethiopia.,WHO-TDR clinical research former fellow at AERAS Africa and Rockville, Rockville, MD USA
| | - Melkamu Birhane
- Department of paediatrics and child health, Jimma University, Jimma, Ethiopia
| | - Sisay Bekele
- Department of ophthalmology, Jimma University, Jimma, Ethiopia
| | - Gebre Kibru
- School of Medical laboratory Science, Institute of Health, School of Medical laboratory Science, Jimma University, P.O. Box 1368, Jimma, Ethiopia
| | - Lule Teshager
- School of Medical laboratory Science, Institute of Health, School of Medical laboratory Science, Jimma University, P.O. Box 1368, Jimma, Ethiopia
| | - Yonas Yilma
- Department of Surgery, Jimma University, Jimma, Ethiopia
| | - Yesuf Ahmed
- Department of Obstetrics and Gynaecology, Jimma University, Jimma, Ethiopia
| | - Netsanet Fentahun
- Department of Health education and behavioural health, Jimma University, Jimma, Ethiopia
| | - Henok Assefa
- Department of Epidemiology, Jimma University, Jimma, Ethiopia
| | - Mulatu Gashaw
- School of Medical laboratory Science, Institute of Health, School of Medical laboratory Science, Jimma University, P.O. Box 1368, Jimma, Ethiopia
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Ibeneme S, Maduako V, Ibeneme GC, Ezuma A, Ettu TU, Onyemelukwe NF, Limaye D, Fortwengel G. Hand Hygiene Practices and Microbial Investigation of Hand Contact Swab among Physiotherapists in an Ebola Endemic Region: Implications for Public Health. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5841805. [PMID: 28691027 PMCID: PMC5485314 DOI: 10.1155/2017/5841805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/13/2017] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region. METHOD A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22-59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained. RESULTS The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71-100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics. CONCLUSION Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.
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Affiliation(s)
- S. Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
- UNIRED Research Group, Hochschule Hannover-University of Applied Sciences and Arts, Hannover, Germany
| | - V. Maduako
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - G. C. Ibeneme
- Department of Nursing Sciences, Faculty of Health Sciences & Technology, College of Medicine, University of Nigeria, Enugu Campus, Abakaliki, Ebonyi State, Nigeria
| | - A. Ezuma
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - T. U. Ettu
- National Open University of Nigeria, Owerri Study Centre, Owerri, Imo State, Nigeria
| | - N. F. Onyemelukwe
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - D. Limaye
- UNIRED Research Group, Hochschule Hannover-University of Applied Sciences and Arts, Hannover, Germany
- German UNESCO Unit on Bioethics, Fakultät III-Medien, Information und Design, Hochschule Hannover-University of Applied Sciences and Arts, Hannover, Germany
| | - G. Fortwengel
- UNIRED Research Group, Hochschule Hannover-University of Applied Sciences and Arts, Hannover, Germany
- German UNESCO Unit on Bioethics, Fakultät III-Medien, Information und Design, Hochschule Hannover-University of Applied Sciences and Arts, Hannover, Germany
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Oli AN, Okoli KC, Ujam NT, Adje DU, Ezeobi I. Health professionals' knowledge about relative prevalence of hospital-acquired infections in Delta State of Nigeria. Pan Afr Med J 2016; 24:148. [PMID: 27642486 PMCID: PMC5012833 DOI: 10.11604/pamj.2016.24.148.9270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 04/27/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Hospital-acquired infections (HAIs) constitute a serious global public health challenge, causing great suffering to many people across the globe at any given time. This study ascertains the knowledge of health professionals on the challenge and their compliance with infection control measures. METHODS Validated questionnaires were administered to 660 health professionals and supported with face-to-face interview. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16.0 (SPSS Inc, USA). Chi-square was used to test association between the independent and the outcome variables. Cut-off point for statistical significance was 5% (p value<0.05). RESULTS UTIs (61.4%) followed by Hospital-acquired Pneumonia (55.6%) were known to be the most prevalent HAIs in government hospitals while Staphylococcus aureus (54.4%) was reported the most microbial agent. In private health facilities, Hospital-acquired Pneumonia was known to be the most common (66.1%) while Pseudomonas aeruginosa was the most reported culprit. HAIs were reported to have occurred more in government hospitals and catheterization was the commonest modes of transmission in both health facilities. CONCLUSION The prevalence of HAIs in this state was reported to be high. Although health-care professionals have good knowledge of HAIs, active effort is not always made to identify and resolve them. Standardized surveillance of HAIs is urgently needed.
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Affiliation(s)
- Angus Nnamdi Oli
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu, Anambra State, Nigeria
| | - Kelechi Christian Okoli
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu, Anambra State, Nigeria
| | - Nonye Treasure Ujam
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu, Anambra State, Nigeria
| | - Dave Ufuoma Adje
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Delta State University, Abraka, Nigeria
| | - Ifeanyi Ezeobi
- Department of Orthopedic Surgery, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Amaku-Awka, Anambra State, Nigeria
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Bota R, Ahmed M, Jamali MS, Azeem Q. Knowledge and self-perceived practices regarding infection control among nursing students of a tertiary care hospital. Am J Infect Control 2013; 41:1143-4. [PMID: 23827482 DOI: 10.1016/j.ajic.2013.03.308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 11/16/2022]
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