Kimberley Hospital health-care associated infection prevalence survey 2015/2016
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. On one day in each of the following months, February 2016 and March 2016, all patients hospitalized in one of fifteen selected wards within Kimberley hospital were studied. A total of 326 patients were surveyed. Data was collected according to the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance Systems criteria which included the demographic details of the patients, clinical characteristics and Laboratory findings. 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%. Sixty-seven percent of patients with blood stream infections had a vascular access device (peripheral) in the 48 hours prior to the onset of infection. Forty percent of patients with urinary tract infections had a urinary catheter present within seven days prior to the onset of infection. The most common microorganism isolated was Klebsiella pneumoniae which was prevalent in 37 % of the infections. Hundred and thirty seven patients (42%) were receiving at least one antimicrobial agent and the most common antibiotic prescribed in the hospital was amoxicillin/clavulanic acid (Augmentin). The most prominent resistance profile was to the Penicillin antibiotics (55% of the isolated organisms). The healthcare-associated infection rates were comparable to other studies done in South Africa, Wales and England, however the surgical site infection rate in Kimberley hospital was higher than those found in other studies conducted in South Africa ( 4.60% vs 3.00%) but less than the study conducted in Argentina using the same Methodology (10.19%). 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.
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