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Published on: February 9, 2011
Hospital acquired infections in a private paediatric hospital in Kenya: a retrospective cross-sectional study
Rohini Kalagouda Patil1, Beatrice Kabera2, Charles Kiilu Muia3
1Department of Paediatrics, Gertrude´s Children´s Hospital, Nairobi, Kenya.
Insights
Hospital-acquired infections (HAI) in children are a significant concern. Klebsiella pneumoniae was the most frequent cause of bacterial HAI, with high rates of multidrug resistance, highlighting the need for targeted antimicrobial strategies.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Hospital Epidemiology
Background:
- Hospital-acquired infections (HAI) increase child morbidity, mortality, and healthcare costs.
- Malnutrition and antibiotic misuse in resource-limited settings exacerbate poor outcomes in children.
- Understanding local HAI patterns is crucial for effective antimicrobial stewardship.
Purpose of the Study:
- To investigate the types and prevalence of HAI in children.
- To identify the causative organisms and their antimicrobial susceptibility patterns.
- To inform empirical antimicrobial therapy and combat antimicrobial resistance.
Main Methods:
- Retrospective cross-sectional study design.
- Inclusion of children aged 1 day to 18 years admitted for ≥48 hours (Jan 2015-Dec 2016).
- Analysis of laboratory-confirmed HAI cases and clinical data.
Main Results:
- Fifty-two HAI cases identified in 41 children; 25 were culture-proven bacterial HAI.
- Point prevalence of culture-positive bacterial HAI was 2.62%.
- Gastrointestinal infections (53%) and bloodstream infections (21%) were most common. Klebsiella pneumoniae was the predominant pathogen (61.53% multidrug-resistant).
Conclusions:
- Gastrointestinal and bloodstream infections are the most common HAI in this pediatric cohort.
- Klebsiella pneumoniae is the leading cause of bacterial HAI, often exhibiting multidrug resistance.
- Emerging resistance to cephalosporins and carbapenems by key pathogens necessitates updated treatment guidelines.
Introduction:
Hospital acquired infections (HAI) or infections acquired in a hospital setting significantly increase morbidity and mortality, prolong hospital stay and increase healthcare costs. Factors like malnutrition and irrational use of antibiotics in a resource limited setting contribute to poor outcome in children. Thus a retrospective cross-sectional study was undertaken to study the different types of HAI in children, the different organisms causing them and their sensitivity to different antimicrobials so as to inform appropriate empirical antimicrobial therapy initiation and thus prevent antimicrobial resistance in the region.
Methods:
children aged one day to eighteen years, admitted to the hospital for at least 48 hours, during the period of January 2015 to December 2016, with positive laboratory findings on clinical specimens and clinical features in keeping with HAI were included.
Results:
the total number of HAI were fifty-two infections in forty-one cases of which, twenty-five cases were culture proven bacterial HAI. Six cases had more than one HAI. The point prevalence of culture positive bacterial HAI in this study was 2.62% (95%CI: 3.8-6.7). The gastrointestinal infections (53%), blood stream infections (21%), lower respiratory tract infections (11%) were the commonest hospital acquired infections. Klebsiella Pneumoniae was the most common bacteria causing HAI with 61.53% of multidrug resistance strains.
Conclusion:
gastrointestinal infections were the commonest HAI followed by blood stream infections. The commonest bacteria causing HAI was Klebsiella pneumoniae. The multidrug resistant organisms were Klebsiella Pneumoniae, Enterobacter Cloacae and Acinetobacter baumannii mainly resistant to third and fourth generation cephalosporins and carbapenems.
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