Prevalence of hospital-acquired infections in the university medical center of Rabat, Morocco

International Archives of Medicine

Redouane Abouqal²  Almontacer Charif Chefchaouni³  Fadil Hassouni¹  Ibtissam Khoudri⁵  Amina Barkat⁶  Abderrahim Azzouzi⁴  Rachid Razine⁵ 

[1] Department of Public Health, Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco;Medical Emergency Department, University Medical Center of Rabat, Rabat, Morocco;University Medical Center of Rabat, Rabat, Morocco;Surgical Intensive Care Unit, University Medical Center of Rabat, Rabat, Morocco;Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco;National Center of Neonatology and Nutrition, Children’s Hospital, University Medical Center of Rabat, Rabat, Morocco

关键词: Morocco;    Prevalence survey;    Hospital-acquired infections;   

Others  :  804459
DOI  :  10.1186/1755-7682-5-26

 received in 2012-07-29, accepted in 2012-09-25,  发布年份 2012

【 摘 要 】

Background

The aims of this study were to determine the hospital-acquired infections (HAI) prevalence in all institutions of Rabat University Medical Center, to ascertain risk factors, to describe the pathogens associated with HAI and their susceptibility profile to antibiotics.

Materials and methods

Point-prevalence survey in January 2010 concerning all patients who had been in the hospital for at least 48 hours. At bedside, 27 investigators filled a standardized questionnaire from medical records, temperature charts, radiographs, laboratory reports and by consultation with the ward’s collaborating health professionals. Risk factors were determined using logistic regression.

Results

1195 patients involved, occupancy rate was 51%. The prevalence of HAI was 10.3%. Intensive care units were the most affected wards (34.5%). Urinary tract infection was the most common infected site (35%). Microbiological documentation was available in 61% of HAI. Staphylococcus was the organism most commonly isolated (18.7%) and was methicillin-resistant in 50% of cases. In multivariate analysis, risk factors associated with HAI were advanced age, longer length of hospital stay, presence of comorbidity, invasive devices and use of antibiotic use.

Conclusion

HAI prevalence was high in this study. Future prevention program should focus on patients with longer length of stay, invasive devices, and overprescribing antibiotics.

【 授权许可】

   
2012 Razine et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Sanchez-Paya J, Bischofberger C, Lizan M, Lozano J, Munoz Platon E, Navarro J, Paz J, Vicente JA: Nosocomial infection surveillance and control: current situation in Spanish hospitals. J Hosp Infect 2009, 72:50-56.
• [2]Freeman J, Hutchison GB: Prevalence, incidence and duration. Am J Epidemiol 1980, 112:707-723.
• [3]Gastmeier P, Kampf G, Wischnewski N, Hauer T, Schulgen G, Schumacher M, Daschner F, Rüden H: Prevalence of nosocomial infections in representative German hospitals. J Hosp Infect 1998, 38:37-49.
• [4]French GL, Cheng AF, Wong SL, Donnan S: Repeated prevalence surveys for monitoring effectiveness of hospital infection control. Lancet 1989, 2:1021-1023.
• [5]Maugat S, Carbonne A, Astagneau P: Significant reduction of nosocomial infectious: stratified analysis of prevalence national studies performed in 1996 and 2001 in French north interegion. Pathol Biol (Paris) 2003, 51:483-489.
• [6]Metintas S, Akgun Y, Durmaz G, Kalyoncu C: Prevalence and characteristics of nosocomial infections in a Turkish university hospital. Am J Infect Control 2004, 32:409-413.
• [7]El Rhazi K, Elfakir S, Berraho M, Tachfouti N, Serhier Z, Kanjaa C, Nejjari C: Prevalence and risk factors for nosocomial infections in Hassan II University Hospital, Fes, Morocco. East Mediterr Health J 2007, 13:56-63.
• [8]Jroundi I, Khoudri I, Azzouzi A, Zeggwagh AA, Benbrahim NF, Hassouni F, Oualine M, Abouqal R: Prevalence of hospital-acquired infection in a Moroccan university hospital. Am J Infect Control 2007, 35:412-416.
• [9]Wolters U, Wolf T, Stutzer H, Schroder T: ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 1996, 77:217-222.
• [10]Mc Cabe WRJG: Gram-negative bacteremia: etiology and ecology. Arch Inern Med 1963, 110:847-855.
• [11]Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med 1985, 13:818-829.
• [12]Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, Banerjee SN, Edwards JR, Tolson JS, Henderson TS: Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991, 91:152S-157S.
• [13]Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM: CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988, 16:128-140.
• [14]Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG: CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992, 13:606-608.
• [15]Lizioli A, Privitera G, Alliata E, Antonietta Banfi EM, Boselli L, Panceri ML, Perna MC, Porretta AD, Santini MG, Carreri V: Prevalence of nosocomial infections in Italy: result from the Lombardy survey in 2000. J Hosp Infect 2003, 54:141-148.
• [16]Sax HPD: Résultats de l’enquête nationale de prévalence des infections nosocomiales de 2004 (snip04). Swiss-NOSO 2005, 12:1-4.
• [17]Eriksen HM, Iversen BG, Aavitsland P: Prevalence of nosocomial infections in hospitals in Norway, 2002 and 2003. J Hosp Infect 2005, 60:40-45.
• [18]van der Kooi TII, Manniën J, Wille JC, van Benthem BHB: Prevalence of nosocomial infections in The Netherlands, 2007–2008: results of the first four national studies. J Hosp Infect 2010, 75:168-172.
• [19]Réseau d’alerte diedsdinR: Enquête nationale de prévalence des infections nosocomiales. Edited by Saint-Maurice. France: sanitaire Idv; 2009.
• [20]Dia NM, Ka R, Dieng C, Diagne R, Dia ML, Fortes L, Diop BM, Sow AI, Sow PS: Prevalence of nosocomial infections in a university hospital (Dakar, Senegal). Med Mal Infect 2008, 38:270-274.
• [21]Kallel H, Bahoul M, Ksibi H, Dammak H, Chelly H, Hamida CB, Chaari A, Rekik N, Bouaziz M: Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect 2005, 59:343-347.
• [22]Navoa-Ng JA BR, Berba R, Galapia YA, Rosenthal VD, Villanueva VD, Tolentino MCV, Genuino GA, Consunji RJ, Mantaring JB 3rd: Device-associated infections rates in adult, pediatric, and neonatal intensive care units of hospitals in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings. Am J Infect Control 2011, 39:548-554.
• [23]Rosenthal VD, Maki DG, Jamulitrat S, Medeiros EA, Todi SK, Gomez DY, Leblebicioglu H, Abu Khader I, Miranda Novales MG, Berba R, Ramírez Wong FM, Barkat A, Pino OR, Dueñas L, Mitrev Z, Bijie H, Gurskis V, Kanj SS, Mapp T, Hidalgo RF, Ben Jaballah N, Raka L, Gikas A, Ahmed A, le TA T, Guzmán Siritt ME, INICC Members: International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003–2008, issued June 2009. Am J Infect Control 2010, 38(e2):95-104.
• [24]Madani N, Rosenthal VD, Dendane T, Abidi K, Zeggwagh AA, Abouqal R: Health-care associated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco: findings of the International Nosocomial Infection Control Consortium (INICC). Int Arch Med 2009, 2:29.
• [25]Datta PRH, Chauhan R, Gombar S, Chander J: Device-associated nosocomial infection in the intensive care units of a tertiary care hospital in northern India. J Hosp Infect 2010, 76:177-189.
• [26]Kwak YG, Leo SO, Kim HY, Kim YK, Park ES, Jin HY, Choi HJ, Jeong SY, Kim ES, Ki HK, Kim SR, Lee JY, Hong HK, Kim S, Lee YS, Oh HB, Kim JM: Korean Nosocomial Infections Surveillance System (KONIS). Risk factors for device-associated infection related toorganisational characteristics of intensive careunits: findings from the Korean Nosocomial Infections Surveillance System. J Hosp Infect 2010, 75:195-199.
• [27]Kishi DVR: Description of Nosocomial Infection Prevention Practices by Anesthesiologists in a University Hospital Brazilian. Journal of Anesthesiology 2011, 61:177-181.
• [28]Barbut F, Coignard B: Nosocomial infections. Rev Prat 2006, 56:2065-2071.
• [29]Klavs I, Bufon Luznik T, Skerl M, Grgic-Vitek M, Lejko Zupanc T, Dolinsek M, Prodan V, Vegnuti M, Kraigher A, Arnez Z: Slovenian Hospital-Acquired Infections Survey Group. Prevalance of and risk factors for hospital-acquired infections in Slovenia-results of the first national survey, 2001. J Hosp Infect 2003, 54:149-157.
• [30]Dumpis U, Balode A, Vigante D, Narbute I, Valinteliene R, Pirags V, Martinsons A, Vingre I: Prevalence of nosocomial infections in two Latvian hospitals. Euro Surveill 2003, 8:73-78.
• [31]Amazian K, Rossello J, Castella A, Sekkat S, Terzaki S, Dhidah L, Abdelmoumène T, Fabry J, et les membres du réseau NosoMed: Prévalence des infections nosocomiales dans 27 hôpitaux de la région méditerranéenne. EMHJ 2010, 16:1070-1078.
• [32]Izquierdo-Cubas F, Zambrano A, Fro′meta I, Gutie′rrez A, Bastanzuri M, Guanche H, Rodrı′guez D: National Prevalence of Nosocomial Infections. Cuba 2004. J Hosp Infect 2008, 68:234-240.
• [33]Faria S, Sodano L, Gjata A, Dauri M, Sabato AF, Bilaj A, Mertiraj O, Llazo E, Kodra Y, Schinaia N: The first prevalence survey of nosocomial infections in the University Hospital Centre‘Mother Teresa’ of Tirana, Albania. J Hosp Infect 2007, 65:244-250.