TY - JOUR
T1 - Healthcare-associated infections including neonatal bloodstream infections in a leading tertiary hospital in Botswana
AU - Mpinda-Joseph, Pinkie
AU - Anand Paramadhas, Bene D.
AU - Reyes, Gilberto
AU - Maruatona, Mompoloki Buster
AU - Chise, Mamiki
AU - Monokwane-Thupiso, Baphaleng B.
AU - Souda, Sajini
AU - Tiroyakgosi, Celda
AU - Godman, Brian
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019
Y1 - 2019
N2 - Background: Healthcare-associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to bloodstream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross-sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54% (n = 47) of patients had HAIs, with 48.9% (n = 23) of them lab-confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100%–n = 5), the nephrology unit (50%–n = 4), and the neonatal intensive care unit (41.9%–n = 13). One-fourth of HAIs were site unspecific, 19.1% (n = 9) had surgical site infections (SSIs), 17% (n = 8) ventilator-associated pneumonia/complications, and 10.6% (n = 5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) was the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third-generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.
AB - Background: Healthcare-associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to bloodstream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross-sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54% (n = 47) of patients had HAIs, with 48.9% (n = 23) of them lab-confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100%–n = 5), the nephrology unit (50%–n = 4), and the neonatal intensive care unit (41.9%–n = 13). One-fourth of HAIs were site unspecific, 19.1% (n = 9) had surgical site infections (SSIs), 17% (n = 8) ventilator-associated pneumonia/complications, and 10.6% (n = 5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) was the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third-generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.
KW - Botswana
KW - Coagulase negative staphylococci
KW - Hospital acquired infections
KW - blood stream infections
KW - infection prevention and control committee
KW - intensive care
UR - http://www.scopus.com/inward/record.url?scp=85074238317&partnerID=8YFLogxK
U2 - 10.1080/21548331.2019.1650608
DO - 10.1080/21548331.2019.1650608
M3 - Article
C2 - 31359809
AN - SCOPUS:85074238317
SN - 2154-8331
VL - 47
SP - 203
EP - 210
JO - Hospital Practice
JF - Hospital Practice
IS - 4
ER -
