Abstract:
Background: Nosocomial infections are the most challenging problem in all health care systems. In developing
countries many people are dying daily due to inadequate health care services of which postoperative infections constitute a
large proportion of this burden. Objective: The aim of this study was to identify risk factors associated for post operative
nosocomial infections among operated patients at Felege Hiwot Referral Hospital. Methods: A cross-sectional study was
conducted on patients who under gone operations from October 2010 to January 2011. A structured questionnaire was used
for collection of data on socio-demographic characteristics and associated risk factors. The clinical diagnosis was made by
respective surgeons and gynaecologists. Bacterial culture confirmation was done for all patients who developed clinical signs
and symptoms of surgical site (SSI) and/or bloodstream infection (BSI) starting from the second day of admission until the
time of discharge using standard bacteriological techniques. Bivariate analysis was made to generate to identify associated
risk factors. P.value < 0.05 was considered as stastically significant. Results: A total of 294 patients were included in the study.
The rate of postoperative culture confirmed nosocomial infection was 10.9%. The infection rate was higher in females (11.6%)
than males (9.4%) (OR=1.27, CI=0.564- 2.863). Patients age of >51 years old were likely to develop post operative
nosocomial infection (OR=6.38, CI=1.156-35.14). Patient with underlying diseases (OR=2.725, CI=1.269-5.853) and
patients who undergone appendectomy ( OR=3.1, CI=1.1-8.3) were more likely developed post operative nosocomial
infections. Operation duration of 91-150 minutes (OR=11.00, CI=1.989-60.83), and postoperative hospital stay of greater
than 15 days (OR=82.00, CI=5.738-1.172) were also likely to be risk factor for infection. Conclusion: This study confirmed
that advanced age, underlying disease, extended preoperative and postoperative hospital stay, longer duration of surgery and
appendectomy were the most likely risk factors for post operative infections. Hence, more attention is required in
management of such cases through prior identification of underlying disease, use of effective antibiotics as a prophylaxis and
adherence of strict aseptic operating procedures.
