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Nosocomial bacterial infections among children with severe protein energy malnutrition
H Isaack1, R L Mbise, K F Hirji
1Department of Paediatrics and Child Health, Faculty of Medicine, University of Dar es Salaam, Tanzania.
Insights
Severely malnourished children in pediatric wards frequently acquire bacterial infections, with Staphylococcus aureus and gram-negative bacteria being common. Urgent preventive measures are needed to reduce hospital-acquired infections.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Hospital-acquired infections (nosocomial infections) pose a significant threat to vulnerable patient populations.
- Malnourished children are particularly susceptible to infections, increasing morbidity and mortality.
- Understanding the epidemiology of bacterial infections in pediatric wards is crucial for effective control.
Purpose of the Study:
- To determine the incidence and types of acute bacterial infections in severely malnourished children admitted to pediatric wards.
- To identify common bacterial pathogens and their antimicrobial susceptibility patterns.
- To assess the contribution of the hospital environment to the spread of infections.
Main Methods:
- A prospective study was conducted on 164 severely malnourished children admitted to pediatric wards.
- Bacterial cultures were performed on patient samples and environmental surfaces (floors, beds, towels, sinks, antiseptic containers).
- Antimicrobial susceptibility testing was performed on isolated pathogens.
Main Results:
- Ninety-two percent of children had at least one bacterial infection on admission.
- 49% acquired new infections during a two-week hospital stay.
- Septicemia (caused mainly by Staphylococcus aureus) and urinary tract infections (UTIs) (caused by Escherichia coli and Klebsiella species) were most common.
- Similar pathogens were found in patient samples and environmental swabs.
- Staphylococcus aureus was sensitive to cloxacillin, erythromycin, and gentamicin; gram-negative organisms were sensitive to gentamicin.
Conclusions:
- Hospital-acquired bacterial infections are highly prevalent among severely malnourished children in pediatric wards.
- The hospital environment likely contributes to the transmission of pathogens.
- Urgent implementation of preventive strategies, including enhanced nursing care, environmental hygiene, and reduced hospital stay duration, is necessary.
Abstract:
The incidence of hospital acquired acute bacterial infections among 164 severely malnourished children admitted to the paediatric wards at the Muhimbili Medical Centre in Dar es Salaam were studied. On admission, ninety two per cent of the patients had at least one form of bacterial infection. During the subsequent two weeks hospital stay, 49% of the patients acquired a new infection. Septicaemia and urinary tract infection (UTI) were the commonest infections. Staphylococcus aureus was the commonest organism in the former, while gram negative organisms, Escherichia coli and Klebsiella species, were predominant in the latter. Pathogens similar to those found from patients were cultured from random samples taken from the floor, beds, towels, sinks and antiseptic containers in the wards. Sensitivity patterns of isolated pathogens to antimicrobial agents showed that S. aureus was highly sensitive to cloxacillin, erythromycin, and gentamicin, while the gram negative organisms were highly sensitive to gentamicin. Our study shows that the problem of nosocomial infection in paediatric wards requires urgent attention. There is a need to institute preventive measures including provision of proper nursing care, maintenance of sterile environment, and reduction of duration of hospital stay.