| Antimicrobial Resistance and Infection Control | |
| Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012 | |
| Théodora Angèle Ahoyo3  Honoré Sourou Bankolé3  Franck Mansour Adéoti5  Aimé Attolou Gbohoun4  Sibylle Assavèdo4  Marcellin Amoussou-Guénou4  Dorothée Akoko Kindé-Gazard2  Didier Pittet1  | |
| [1] Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland | |
| [2] Ministry of Health and Faculty of Medicine, University of Abomey-Calavi, Cotonou, Benin | |
| [3] Génie de Biologie Humaine, Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin | |
| [4] Improvement Quality Service, Ministry of Health, Cotonou, Benin | |
| [5] International Network for Planning and Improving Quality and Safety in Health Systems in Africa (Réseau International pour la Planification et l’Amélioration de la Qualité et la Sécurité dans les établissements humains en Afrique), Abidjan, Ivory Coast | |
| 关键词: Low-/middle-income countries; Africa; Surveillance; National surveillance; Infection control; Antibiotic use; Co-morbidity; Antimicrobial resistance; Prevalence; Nosocomial infection; | |
| Others : 790447 DOI : 10.1186/2047-2994-3-17 |
|
| received in 2014-01-09, accepted in 2014-04-09, 发布年份 2014 | |
PDF
|
|
【 摘 要 】
Background
Data on nosocomial infections in hospitals in low-income countries are scarce and often inconsistent. The objectives of this study were to estimate the prevalence of nosocomial infections and antimicrobial drug use in Benin hospitals.
Methods
All hospitals were invited to participate in the first national point prevalence study conducted between 10–26 October 2012 using the protocol developed by the “Hospitals in Europe Link for Infection Control through Surveillance” (HELICS) project. Infection prevalence rates and the proportion of infected patients and exposure to antimicrobials were assessed.
Results
Overall, 87% (39/45) of hospitals participated. Of 3130 inpatients surveyed, 972 nosocomial infections were identified among 597 patients, representing an overall prevalence of infected patients of 19.1%. The most frequent infections were related to the urinary tract (48.2%), vascular catheter use (34.7%), and surgical site (24.7%). 64.6% of patients surveyed were treated with antibiotics, including a significant proportion (30%) of non-infected patients and a high proportion of self-medication (40.8%). Resistance of leading nosocomial pathogens to antimicrobials included methicillin-resistance (52.5%) among Staphylococcus aureus, vancomycin resistance among enterococci (67.5%), cefotaxime resistance among Escherichia coli (67.6%), and ceftazidime resistance among Acinetobacter baumannii (100%) and Pseudomonas aeruginosa (68.2%).
Conclusions
Benin has high nosocomial infection rates and calls for the implementation of new national infection control policies. Patient safety education and training of all individuals involved in healthcare delivery will be critical to highlight awareness of the burden of disease. The high use of antimicrobials needs to be addressed, particularly their indiscriminate use in non-infected patients.
【 授权许可】
2014 Ahoyo et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20140705000541364.pdf | 173KB |
【 参考文献 】
- [1]Gastmeier P, Kampf G, Wischnewski N, Schumacher M, Daschner F, Ruden H: Importance of the surveillance method: national prevalence studies on nosocomial infections and the limits of comparison. Infect Control Hosp Epidemiol 1998, 19:661-667.
- [2]Rebaudet S, De Pina J-J, Rapp C, Kraemer P, Savini H, Demortiere E, Simon F: Le risque nosocomial en Afrique intertropicale - Partie 4: prévention. Med Trop 2007, 68:73-82.
- [3]Raza MW, Kazi BM, Mustafa M, Gould FK: Developing countries have their own characteristic problems with infection control. J Hosp Infect 2004, 57:294-299.
- [4]Hospitals in Europe Link for Infection Control through Surveillance (HELICS): Prevalence Surveys of Nosocomial Infections. 2004. http://www.eurosurveillance.org/ webcite
- [5]Simon F, Kraemer P, De Pina JJ, Demortiere E, Rapp C: Le risque nosocomial en Afrique intertropicale - Partie 2: les infections des patients. Med Trop 2007, 67:197-203.
- [6]Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D: Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011, 377:228-241.
- [7]Western KA, St John RK, Shearer LA: Hospital infections control- an international perspective. Infect Control 1982, 3:453-455.
- [8]Bagheri Nejad S, Allegranzi B, Syed SB, Ellis B, Pittet D: Health-care-associated infection in Africa: a systematic review. Bull World Health Organ 2011, 89:757-765.
- [9]Ahoyo TA, Baba-Moussa F, Adeoti MF, Attolou G, Boco M, Kotchoni S, Baba-Moussa L: Serratia marcescens outbreak on a general pediatric ward in Benin. J Pharm Biomed Sci 2012, 24:35-39.
- [10]Ahoyo AT, Baba-Moussa L, Anagob AE, Avogbe P, Missihouna TD, Loko F, Prévostc G, Sannia A, Dramane K: Incidence of infections due to Escherichia coli strains producing extended-spectrum beta-lactamase, in the Zou/Collines Hospital Centre (CHDZ/C) in Benin. Med Mal Infect 2007, 37:746-752.
- [11]Blomberg B, Mwakagile DSM, Urassa WK, Maselle SY, Mashurano M, Digranes A, Stig Harthug S, Langeland N: Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. BMC Public Health 2004, 4:45. BioMed Central Full Text
- [12]Coignard B, Thiolet J, Lacavé L: Enquête nationale de prévalence des infections nosocomiales, juin 2006. Résultats préliminaires. Institut de veille sanitaire (RAISIN) 2007.
- [13]National Nosocomial Infections Surveillance (NNIS): System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004, 32:470-485. https://kce.fgov.be/sites/default/files/page_documents/d20081027371.pdf webcite
- [14]Pittet D, Ruef C: et le Comité de Swiss-NOSO. Première enquête nationale de prévalence des infections nosocomiales dans les hôpitaux universitaires suisses. Swiss-NOSO 2000, 7:1-3.
- [15]Freney J, Renaud F, Hansen W, Bollet C: Précis de bactériologie clinique. Paris: Editions ESKA; 2000.
- [16]National Committee for Clinical Laboratory Standards: Performance standards for antimicrobial disk susceptibility tests. Approved standard. 7th edition. Wayne (PA): NCCLS document M2-A7 NCCLS; 2000.
- [17]Thapar N, Sanderson IR: Diarrhoea in children: an interface between developing and developed countries. Lancet 2004, 363:641-653.
- [18]Nauciel C, Vilde JL: Bactériologie médicale. 2nd edition. Paris; 2005:49-58. [Editions Masson]
- [19]Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG, Jenkins P, O'Brien TF, Pablos-Mendez A, Klugman KP: Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis 2005, 5:481-493.
- [20]Ahoyo AT, Baba-Moussa L, Makoutode M, Gbohoun A, Bossou R, Dramane K, Sanni A, Prévost G: Incidence of meticillin–resistant Staphylococcus aureus in the neonatal care unit of the departmental hospital centre of Zou Collines in Benin. Arch Péd 2006, 13:1391-1396.
- [21]Kunin C: Resistance to antimicrobial drugs. A worldwide calamity. Ann Intern Med 1993, 118:557-561.
- [22]Trostle J: Inappropriate distribution of medicines by professionals in developing countries. Soc Sci Med 1996, 42:1117-11120.
- [23]Kampf G, Lecke C, Cimbal A-K, Weist K, Rüden H: Evaluation of mannitol salt agar for detection of oxacillin resistance in Staphylococcus aureus by disk diffusion and agar screen. J Clin Microbiol 1998, 36:2254-2257.
PDF