Assessment of outcome of nosocomial infections and associated factors among pediatric patients admitted at JUMC, Ethiopia

Abstract

Background: Nosocomial infections are infections that occur in patients during their hospital stay and were not present or incubating at the time of admission. Typically, these infections develop 48 hours after hospital admission and can appear up to seven days after discharge. NI represent a significant threat to patient safety, often resulting in prolonged hospital stays, long term health complications, increased resistance to antimicrobial drugs, and a greater risk of mortality. Furthermore, they contribute to a substantial financial burden on healthcare systems and impose significant emotional and economic stress on patients and their families. Globally, hundreds of millions of people every year are affected by NIs, many of which are completely avoidable. No country or health system, even the most developed or sophisticated, can claim to be free of NIs. Objective: To assess the outcome of nosocomial infections and associated factors among pediatric patients admitted at JUMC, Jimma, Ethiopia Methods: An institution-based longitudinal study design was conducted on pediatric patients with nosocomial infections from Nov, 2024 to Nov , 2025.Data were collected by using structured questionnaire the collected data was entered into Epi Data 3.1 and exported to SPSS (statistical package for social sciences) version 25.0 for further analysis. Descriptive analysis as well as bivariate and multi-variable logistic regression analyses was conducted. Statistical significance was considered at p-values <0.05 and 95% Confidence Interval (CI). Results are presented as narratives and using tables and figures. Result: A total of 282 patients diagnosed with NI were included in the study. More than half of them were male 158(56%), with mean age of 2.1 ± (SD=1.1years ) Most children were admitted to the General Ward (41.7%) and the Oncology Ward (31.9%), followed by the Neonatal Intensive Care Unit (NICU) (19.4%).Most common type of Nosocomial infection among pediatric patient was blood stream infection observed in 208 (73.8%), and followed by pneumonia in 42(14.95%). A majority of the children (68.2%) had co-morbid diseases and 266(94.3%) were non-reactive for Serostatus.A total of 165 clinical samples were taken for culture and 40(24.4%) microorganism were identified. About 12(30%) organism were pseudomonas and CONS 11(27.5%) were isolated and drug sensitivity was observed to meropenium ,Vancomycin followed by Amikacin.Patients infected with Pseudomonas were about two times more likely to have an unfavorable outcome compared to those infected with other organisms(AOR=2.12;CI=1.07-4.02,P=0.032). Conclusion and recommendation: The overall findings revealed that bloodstream infections (clinical or bacteriological) were the predominant type of hospital-acquired infection and a significant number of patients had underlying comorbidity.The most isolated organism are Gram-negative organisms which is pseudomonas followed by CONS.Most children were improved and discharged with the poorer out come associated with gram -negative infections.The high resistance observed to commonly used antibiotics, particularly cephalosporins, highlights the need for periodic review and updating of empirical treatment protocols