TITLE:
Hospital Acquired Infections at the Service of Pediatric Surgery in Gabriel Touré Academic Hospital, Bamako, Mali
AUTHORS:
Y. Coulibaly, O. Kone, I. Amadou, T. H. M. Diop, O. Coulibaly, A. Doumbia, B. Kamaté, H. Ouologuem, D. Konaté, M. Coulibaly, B. Maiga, M. I. Mangané
KEYWORDS:
Infection, Germs, Sensitivities, Risk Factors, Child, Mali
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.1,
March
9,
2020
ABSTRACT: Introduction:Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the patient or at the time of delivering the care or which does not manifest itself only after the patient has been discharged or an infection contracted by the professional in the course of his duties. Objectives:To identify mean causative germsand to determine their sensitivity to antibiotics and to identify the risk factors ofhealth care-associated infection.Material and methods:It was about a prospective longitudinal study conducted from November 1, 2017 to April 1, 2018(6 months) in all children admitted to the pediatric surgery service. Non-consenting parents and outpatient necrosectomy case have not been included in this study.Results:This study included 200 patients, of whom 30 experienced the hospital acquired infections with an infection rate of 15%. The surgical site infection was the most common type, with 16 cases (53.3%), followed by burns in 13 cases (43.3%) and urinary tract infection in 1 case (3.3%). The average age of patients with infection was 56.33 ± 48.66 months with extremes of 1 and 180 months. The sex ratio was 1.30 for infected patients and was 1.83 for uninfected patients. The main bacteria responsible for surgical site infection were: Escherichia coli(4 cases), Acinetobacter baumanii(3 cases), Klebsiella pneumoniae(2 cases), Staphylococcus aureus(2 cases), Enterobacter cloacae(1 case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis(1 case). Among burn patients, the most frequent germs were: Acinetobacter baumanii(7 cases), Klebsiella pneumoniae(6 cases), Staphylococcus aureus(6 cases), Escherichia coli(4 cases), Pseudomonas aeruginosa(2 cases) and Enterobacter faecalis(2 cases). Escherichia coliwasnoted only in the case of urinary tract infection. Antibiotics tested were: amoxicillin, amoxicillin associated with clavulanic acid, ceftriaxone, imipenem, gentamicin and ciprofloxacin.Germs were resistant to amoxicillin in 88.9% of cases, sensitive to the amoxicillin-clavulanic acid combination in 85% of cases, sensitive to tobramycin and gentamicin. Recruitment methods and length of hospitalization were the risk factors noted. Conclusion:Massive awareness among all healthcare providers should be conducted on the adoption of standard precautions for the prevention of health care-associated infections and on the rules of antibiotics prescription to reduce the incidence of health care-associated infection and slow the resistance of germs to antibiotics.