Hospital-acquired infection in public hospital buildings in the Philippines: Is the type of ventilation increasing the risk?

Abstract

Introduction: Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries. However, limited information is available about the risk of HAIs in naturally ventilated wards (NVWs) and mechanically ventilated intensive care units (MVICUs) of public hospitals in the Philippines. We aimed to assess the association between HAIs and type of ventilation in an urban tertiary care hospital in the Philippines. Methodology: A cross-sectional point-prevalence survey of infections was done in NVWs and MVICUs of a tertiary care hospital in December 2013. Multivariate analyses were done to examine the associations between HAIs and type of ventilation and other risk factors. Results: Of the 224 patients surveyed, 63 (28%) patients had 69 HAIs. Pneumonia was the most common HAI (35%). Wards near areas with high vehicular activity had more respiratory HAI cases. Being immunocompromised is a risk factor for HAI for pediatric and adult patients. Among pediatric patients, staying in MVICUs had a lower risk for HAIs (adjusted odds ratio [AOR]: 0.33; 95% confidence interval [CI]: 0.10-1.08) compared to staying in NVWs. For adult patients, a higher risk for HAIs (AOR: 2.41; 95% CI: 0.29-18.20) was observed in MVICUs compared to NVWs. Conclusions: Type of ventilation is not a risk factor for HAIs. Patients who are immunocompromised may be at a higher risk for HAI. Indoor air pollution, proximity to congested main thoroughfare, and increased human foot traffic may contribute to the susceptibility of patients to HAIs. Hospital layout should be considered in infection control.

Indoor Air Quality in Healthcare Units—A Systematic Literature Review Focusing Recent Research

“…The importance of adequate particle filtration systems is also highlighted in several studies [43,[59][60][61][62]. The influence of ventilation on the prevalence of hospital infections has also been studied [54,62,63], including studies on SARS-CoV-2 infection [27,53,55,64,65]. Cleaning procedures also have an important role in the control of microbiological loads [14,53,66,67].…”

Are Invasive Procedures and a Longer Hospital Stay Increasing the Risk of Healthcare-Associated Infections among the Admitted Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia?

“…In this study, the odds of developing HCAIs were 5-fold higher in cigarette smokers compared to nonsmokers. A number of studies reported that cigarette smoking increases the likelihood of having an infection such as invasive pneumococcal disease, periodontitis, meningococcal disease, tuberculosis, surgical wound infections, and postoperative mediastinitis [30][31][32] although they failed to give statistical significance supporting these findings.…”