Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana

Pinkie Mpinda-Joseph, Bene D Anand Paramadhas, Gilberto Reyes, Mompoloki Buster Maruatona, Mamiki Chise, Baphaleng B Monokwane-Thupiso, Sajini Souda, Celda Tiroyakgosi, Brian Godman

Research output: Contribution to journalArticle

Abstract

Background: Healthcare associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to blood stream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54% (n=47) of patients had HAIs, with 48.9% (n=23) of them lab confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100% - n=5), the nephrology unit (50% - n=4), and the neonatal intensive care unit (41.94% - n=13). One fourth of HAIs were site unspecific, 19.1% (n=9) had surgical site infections (SSIs), 17% (n=8) ventilator associated pneumonia/complications, and 10.6% (n=5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) were the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.
LanguageEnglish
Number of pages8
JournalHospital Practice
Early online date27 Aug 2019
DOIs
Publication statusE-pub ahead of print - 27 Aug 2019

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Botswana
Cross Infection
Tertiary Care Centers
Infection
Enterococcus
Infection Control
Length of Stay
Newborn Infant
Surgical Wound Infection
Ventilator-Associated Pneumonia
Hospital Laboratories
Acinetobacter
Nephrology
Pressure Ulcer
Hospital Costs
Coagulase
Neonatal Intensive Care Units
Cephalosporins
Critical Care
Microbial Drug Resistance

Keywords

  • hospital acquired infections
  • blood stream infections
  • intensive care
  • coagulase negative staphylococci
  • Botswana
  • infection prevention and control committee

Cite this

Mpinda-Joseph, Pinkie ; Paramadhas, Bene D Anand ; Reyes, Gilberto ; Maruatona, Mompoloki Buster ; Chise, Mamiki ; Monokwane-Thupiso, Baphaleng B ; Souda, Sajini ; Tiroyakgosi, Celda ; Godman, Brian. / Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana. In: Hospital Practice. 2019.
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title = "Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana",
abstract = "Background: Healthcare associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71{\%} of neonates are prone to blood stream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54{\%} (n=47) of patients had HAIs, with 48.9{\%} (n=23) of them lab confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100{\%} - n=5), the nephrology unit (50{\%} - n=4), and the neonatal intensive care unit (41.94{\%} - n=13). One fourth of HAIs were site unspecific, 19.1{\%} (n=9) had surgical site infections (SSIs), 17{\%} (n=8) ventilator associated pneumonia/complications, and 10.6{\%} (n=5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) were the commonest organism (31.97{\%}) isolated followed by Enterococci spp. (18.03{\%}) among neonates. Prescribing of third generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.",
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author = "Pinkie Mpinda-Joseph and Paramadhas, {Bene D Anand} and Gilberto Reyes and Maruatona, {Mompoloki Buster} and Mamiki Chise and Monokwane-Thupiso, {Baphaleng B} and Sajini Souda and Celda Tiroyakgosi and Brian Godman",
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Mpinda-Joseph, P, Paramadhas, BDA, Reyes, G, Maruatona, MB, Chise, M, Monokwane-Thupiso, BB, Souda, S, Tiroyakgosi, C & Godman, B 2019, 'Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana' Hospital Practice. https://doi.org/10.1080/21548331.2019.1650608

Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana. / Mpinda-Joseph, Pinkie ; Paramadhas, Bene D Anand; Reyes, Gilberto ; Maruatona, Mompoloki Buster; Chise, Mamiki ; Monokwane-Thupiso, Baphaleng B; Souda, Sajini; Tiroyakgosi, Celda; Godman, Brian.

In: Hospital Practice, 27.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana

AU - Mpinda-Joseph, Pinkie

AU - Paramadhas, Bene D Anand

AU - Reyes, Gilberto

AU - Maruatona, Mompoloki Buster

AU - Chise, Mamiki

AU - Monokwane-Thupiso, Baphaleng B

AU - Souda, Sajini

AU - Tiroyakgosi, Celda

AU - Godman, Brian

PY - 2019/8/27

Y1 - 2019/8/27

N2 - Background: Healthcare associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to blood stream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54% (n=47) of patients had HAIs, with 48.9% (n=23) of them lab confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100% - n=5), the nephrology unit (50% - n=4), and the neonatal intensive care unit (41.94% - n=13). One fourth of HAIs were site unspecific, 19.1% (n=9) had surgical site infections (SSIs), 17% (n=8) ventilator associated pneumonia/complications, and 10.6% (n=5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) were the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.

AB - Background: Healthcare associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to blood stream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns. Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database. Results: 13.54% (n=47) of patients had HAIs, with 48.9% (n=23) of them lab confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100% - n=5), the nephrology unit (50% - n=4), and the neonatal intensive care unit (41.94% - n=13). One fourth of HAIs were site unspecific, 19.1% (n=9) had surgical site infections (SSIs), 17% (n=8) ventilator associated pneumonia/complications, and 10.6% (n=5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) were the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections. Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.

KW - hospital acquired infections

KW - blood stream infections

KW - intensive care

KW - coagulase negative staphylococci

KW - Botswana

KW - infection prevention and control committee

UR - https://www.tandfonline.com/toc/ihop20/current

U2 - 10.1080/21548331.2019.1650608

DO - 10.1080/21548331.2019.1650608

M3 - Article

JO - Hospital Practice

T2 - Hospital Practice

JF - Hospital Practice

SN - 2154-8331

ER -