Prevalence, Clinical Profile and Risk Factors of Nosocomial Infection in Ayder Pediatric Intensive Care Unit, Tigray, Ethiopia

Abstract

Background Hospital-acquired infection (HAI) is a significant cause of increased morbidity and mortality amongst hospitalized patients and represents a considerable health and economic burden worldwide. However, evidence about HAI in pediatric ICU is limited. Objective To identify the prevalence of hospital-acquired infection (HAI), clinical profile, and its risk factors for nosocomial infection in patients admitted to the pediatric intensive care unit (PICU). Methodology From a two-year retrospective chart review admitted from 2019 to 2020 to the PICU, 223 patients were selected by systematic random sampling. Data were analyzed in SPSS version 23.0. P-values <0.05 were considered significant for all tests. Results Forty-five (20.2%) patients developed nosocomial infection (NI). The median age was 4 years with 25–50th IQR of (0.6–9). About invasive procedures done, the most common was nasogastric tube (57%), followed by mechanical ventilation (17.9%) and urinary catheter (13.9%). The main focus of the infection was chest (53.3%), followed by bloodstream infection (22%) and gastrointestinal infection (9%). The odds of HAI were 3.3 times higher among under-five compared to those aged between 5 and 18 years (AOR: 3.3, 95% CI = 1.4–8.0, p = 0.008). The odds of HAI were also 4.1 times higher in those who stayed for more than two weeks compared to those who stayed in the pediatric ICU 2 to 14 days (AOR: 4.1, 95% CI = 2.0–8.6, p < 0.001). The mean duration of mechanical ventilation in those patients with and without NI was 1.65 days and 13.96 days, respectively (AOR = 3.46, 95% CI = 1.44–9.81, p = 0.02). Patients who started antibiotics at admission and patients who were on nasogastric tube feeding were also statistically significant risk factors for developing NI (AOR = 2.67, 95% CI = 1.37–9.64, p = 0.02; AOR = 2.45, 95% CI = 1.64–6.53, p = 0.03). Conclusion The rate of infection in this study was higher compared to some developing countries. Younger age and prolonged length of hospital stay were found to be significant risk factors for HAI.

Prevalence of nosocomial infection and associated factors among paediatric patients admitted to Jimma medical center, Oromia region, southwest Ethiopia. Cross-Sectional Study

“…The current study also demonstrated that paediatric patients who received antibiotics at admission had 4.76 times higher odds of developing nosocomial infections compared to those who did not receive antibiotics at admission. This finding is similar to the study conducted at Ayder Hospital (26). One potential explanation for this association could be overuse or inappropriate use of antibiotics, which can lead to antibiotic resistance and subsequent infections.…”

“…The odds of developing nosocomial infections among paediatric patients who were malnourished were 2.01 times higher compared to those who were well-nourished [AOR=2.01; 95%CI(1.18, 5). (25) and Ayder Hospital (20.2%) (26). However, it is higher when compared to previous studies conducted in Ecuador (13.5%) (36), Switzerland (6.7%) (28), the Philippines (11.37%) (37), the South of Iran (14.57%) (38), and Kenya (2.62%) (39).…”

“…The data collection tools were adapted after a review of different relevant literature (25)(26)(27)29,(33)(34)(35). The tools were prepared in the English language.…”

Epidemiology and Risk Factors of Nosocomial Infection in Hospitalized Children and Adults: A Review

“…The mean duration of mechanical ventilation in those patients with and without NI was 1.65 days and 13.96 days, respectively. Patients who started antibiotics at admission and patients who were on nasogastric tube feeding were also statistically significant risk factors for developing NI [21] . As a conclusion, the review identified a number of essential details about the rate of HAIs in different parts of the world.…”