Associated Risk factors for Postoperative Nosocomial infections among Patients admitted at Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

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.