You are here:

Incidence of healthcare-associated infections with invasive devices and surgical procedures in Nepal

Published on


To ensure that scientific research of immediate concern is shared as rapidly as possible, we fast-track accepted articles from the IJTLD and PHA and publish them as edited preprints prior to publication in an issue.

All content in PHA is Open Access and free to read. PHA covers all areas of operational research including: infection control, nutrition, TB, HIV,  vaccines, smoking, COVID-19, microbial resistance or disease outbreaks. Find out more about PHA or sign-up to receive the Table of Contents

Read the PDF for the full text, including the Figures, Tables and References

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.


Read the PDF for the full text, including the Figures, Tables and References