Hospital acquired infections in a private paediatric hospital in Kenya: a retrospective cross-sectional study

Abstract

Introduction: Hospital acquired infections (HAI) or infections acquired in a hospital setting significantly increase morbidity and mortality, prolong hospital stay and increase healthcare costs. Factors like malnutrition and irrational use of antibiotics in a resource limited setting contribute to poor outcome in children. Thus a retrospective cross-sectional study was undertaken to study the different types of HAI in children, the different organisms causing them and their sensitivity to different antimicrobials so as to inform appropriate empirical antimicrobial therapy initiation and thus prevent antimicrobial resistance in the region.

Methods: children aged one day to eighteen years, admitted to the hospital for at least 48 hours, during the period of January 2015 to December 2016, with positive laboratory findings on clinical specimens and clinical features in keeping with HAI were included.

Results: the total number of HAI were fifty-two infections in forty-one cases of which, twenty-five cases were culture proven bacterial HAI. Six cases had more than one HAI. The point prevalence of culture positive bacterial HAI in this study was 2.62% (95%CI: 3.8-6.7). The gastrointestinal infections (53%), blood stream infections (21%), lower respiratory tract infections (11%) were the commonest hospital acquired infections. Klebsiella Pneumoniae was the most common bacteria causing HAI with 61.53% of multidrug resistance strains.

Conclusion: gastrointestinal infections were the commonest HAI followed by blood stream infections. The commonest bacteria causing HAI was Klebsiella Pneumoniae. The multidrug resistant organisms were Klebsiella pneumoniae, Enterobacter cloacae and Acinetobacter baumannii mainly resistant to third and fourth generation cephalosporins and carbapenems.