What is it about?
This survey was a point-prevalence survey to determine the rates of four of the most important healthcare-associated infections (viz. urinary tract, lower respiratory tract, surgical site and primary bloodstream infections) in Kimberley Hospital in the province of Northern Cape, South Africa. This was the first survey of this kind conducted in the Northern Cape. Where data was available, the infections were linked to the causative microorganism/s and their antimicrobial susceptibility data was explored.
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Why is it important?
HCAI have numerous repercussions. They may lead to an increase in disability, morbidity and even eventually have the potential to result in death. Patients who develop nosocomial infections cost more to health institutions due to an increase in the length of stay (LOS) which in turn is linked to an increase in the use of diagnostic tests and drugs. Infections caused by antimicrobial-resistant pathogens are of a major concern and nosocomial infections are therefore becoming more difficult and expensive to treat. At the same time it has also been noted that a proportion of nosocomial infections (15-30%) may be avoidable.A meta-analysis done in 2011 found that 66% of developing countries worldwide had no published data on the endemic burden of HCAI. Most studies were done at single centres which were often large, referral hospitals in urban areas therefore not representative of the wider healthcare systems in the region. Yet, the available evidence is sufficient to raise concern that nosocomial infections are significantly adding to the already high burden of infection in Sub Saharan Africa. HCAIs need to be properly managed in order to prevent transmission of microorganisms amongst patients, health care workers and visitors to the healthcare facility.
Perspectives
The overall prevalence rate was found to be 7.76% and varied significantly between the major units (with minimum of 20 patients admitted) ranging from 4.54% to 15.15%. The highest rates were noted in the surgical disciplines. Among the individual infection types studied, the highest prevalence was for surgical site infections at 4.60% followed by urinary tract infections (1.53%) and both primary bloodstream Infections and pneumonia (both 0.92%). Among the surgical site infections, superficial incisional subtype made up almost 67% of the infections. The paediatric healthcare-associated infection prevalence was 6.12%. These findings do indicate that the overall infection prevalence rates found in Kimberley Hospital is in keeping with international trends but the prevalence of surgical site infections are of concern and further studies are needed to identify the relevant risk factors involved and target this as an area where preventative interventions can be implemented. This survey also provided a baseline for Kimberley hospital against which future prevalence surveys can be compared.
Dr Arun Nair
University of the Free State
Read the Original
This page is a summary of: Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa, South African Family Practice, July 2018, Taylor & Francis,
DOI: 10.1080/20786190.2018.1487211.
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