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P. Koju, X. Liu, R. Zachariah, M. Bhattachan, B. Maharjan, S. Madhup, H. D. Shewade, A. Abrahamyan, P. Shah, S. Shrestha, H. Li, R. Shrestha
SETTING: Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu, Nepal.
OBJECTIVES: 1) To report the incidence of healthcare-associated infections (HAIs), 2) to compare demographic, clinical characteristics and hospital outcomes in those with and without HAIs; and 3) to verify bacterial types in HAI and community-acquired infections (CAIs) among inpatients with invasive devices and/or surgical procedures.
DESIGN: This was a cohort study using secondary data (December 2017 to April 2018).
RESULTS: Of 1,310 inpatients, 908 (69.3%) had surgical procedures, 125 (9.5%) had invasive devices and 277 (21.1%) both. Sixty-six developed HAIs (incidence = 5/100 patient admissions, 95% CI 3.9–6.3). Individuals with HAIs had a 5.5-fold higher risk of longer hospital stays (≥7 days) and a 6.9-fold risk of being in intensive care compared to the surgical ward. Unfavourable hospital exit outcomes were higher in those with HAIs (4.5%) than in those without (0.9%, P = 0.02). The most common HAI bacteria (n = 70) were Escherichia coli (44.3%), Enterococcus spp. (22.9%) and Klebsiella spp. (11.4%). Of 98 CAIs with 41 isolates, E. coli (36.6%), Staphylococcus aureus (22.0%) and methicillin-resistant S. aureus(14.6%) were common.
CONCLUSION: We found relatively low incidence of HAIs, which reflects good infection prevention and control standards. This study serves as a baseline for future monitoring and action.