Prepandemic National Prevalence of Hospital Acquired Infections, Risk Factors and Antibiotic Resistance in Tunisia

Résumé fourni par la source

Background: In Tunisia, there is a poorness of data describing prepandemic Hospital Acquired Infections (HAIs).Aim: This study aims to describe prevalence and distribution of HAIs in Tunisian public and private hospitals and to identify their main risk factors.Methods: A point-prevalence national cross-sectional survey was conducted between November and December 2012.Data were collected using a standardized protocol of the Centre for Disease Control (CDC) Atlanta.Results: A total of 132 hospitals representing 67.4% beds in public and private hospitals were surveyed.Of 8608 inpatients included, 575 had at least one HAI corresponding to an overall prevalence of 6.7%.The main factors associated to HAIs were hospitalization in intensive care unit (AOR=3.4[1.8-6.4]),suprapubic aspiration (AOR=5.3[2.2-12.5]),central vascular catheter (AOR=3.8[2.7-5.4]),malnutrition (AOR=1.9[1.3-2.6]) and immunosuppression (AOR=1.9[1.5-2.6].Out of the 575 patients, 199 had a microbiological test (34.6%).One microorganism was identified in 68% of cases, two in 31.5% and three and more in other cases.The most common microorganism was Klebsiella Pneumoniae.The national prevalence of antimicrobial use was 43.0% (95%CI [42.0%-44.0%]).Antibiotic resistance phenotypes were identified in 82.6% of isolated bacteria.Conclusion: Our results highlighted the need to implement targeted prevention control measures especially an early warning system for HAIs in departments at risk and a national antibiotic stewardship program to fight against emergence and spread of multi-resistant bacteria.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.