Healthcare-associated infections and antimicrobial use in surgical wards of a large urban central hospital in Blantyre, Malawi: a point prevalence survey

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Healthcare-associated infections and antimicrobial use in surgical wards of a large urban central hospital in Blantyre, Malawi: a point prevalence survey


JournalInfection Prevention in Practice
Article typeJournal research article – Clinical research
Publication date – Jul – 2021
Authors – Gabriel Kambale Bunduki, Nicholas Feasey, Marc Y.R. Henrion, Patrick Noah, Janelisa Musaya
KeywordsAntimicrobial use, Healthcare-associated infection, Infection prevention and control, Malawi, Point-prevalence survey, surgery, Surveillance
Open access – Yes
SpecialityGeneral surgery, Health policy, Other
World region Southern Africa
Country: Malawi
Language – English
Submitted to the One Surgery Index on August 2, 2021 at 8:47 am
Abstract:

Background
There are limited data on healthcare-associated infections (HAI) from African countries like Malawi.

Aim
We undertook a point prevalence survey of HAI and antimicrobial use in the surgery department of Queen Elizabeth Central Hospital (QECH) in Malawi and ascertained the associated risk factors for HAI.

Methods
A cross-sectional point prevalence survey (PPS) was carried out in the surgery department of QECH. The European Centre for Disease Prevention and Control PPS protocol version 5.3 was adapted to our setting and used as a data collection tool.

Findings
105 patients were included in the analysis; median age was 34 (IQR: 24–47) years and 55.2% patients were male. Point prevalence of HAI was 11.4% (n=12/105) (95% CI: 6.0%–19.1%), including four surgical site infections, four urinary tract infections, three bloodstream infections and one bone/joint infection. We identified the following risk factors for HAI; length-of-stay between 8 and 14 days (OR=14.4, 95% CI: 1.65–124.7, p=0.0143), presence of indwelling urinary catheter (OR=8.3, 95% CI: 2.24–30.70, p=0.003) and history of surgery in the past 30 days (OR=5.11, 95% CI: 1.46–17.83, p=0.011). 29/105 patients (27.6%) were prescribed antimicrobials, most commonly the 3rd-generation cephalosporin, ceftriaxone (n=15).

Conclusion
The prevalence rates of HAI and antimicrobial use in surgery wards at QECH are relatively high. Hospital infection prevention and control measures need to be strengthened to reduce the burden of HAI at QECH.

OSI Number – 21195

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