Profile of Nosocomial Infections in an Intensive Care Unit in Sub-Saharan Africa (Abidjan, Côte d’Ivoire)
DOI:
https://doi.org/10.18502/aacc.v12i6.22968Keywords:
Nosocomial infection; Intensive care unit; Sub-Saharan AfricaAbstract
Background: Nosocomial infections increase morbidity, mortality, and healthcare costs in intensive care units (ICUs). The study aimed to describe the epidemiological profile and outcomes of nosocomial infections in an ICU in sub-Saharan Africa.
Methods: It was a retrospective and analytical study from January 1st, 2013, to December 31st, 2021, in the intensive care unit of Cocody University Hospital, Abidjan, Côte d’Ivoire. All patients hospitalized for at least 48 hours in the ICU or in the referring department were included.
Results: Among 5330 admissions, 325 patients developed a nosocomial infection (6.1%). Of these, 52% acquired the infection before ICU admission and 48% during their ICU stay. The mean age of the patients was 40 years with a standard deviation of 21 years, and the male-to-female ratio was 1.25. Neurological disorders were the most frequent underlying conditions. Nosocomial pneumonia was the most common infection (49.7%), followed by urinary tract infection (44.2%), bacteremia (37.0%), and other infections (11.1%). Gram-negative bacilli were predominant (79.9%), followed by Gram-positive infections (15.4%) and yeasts (4.7%). The most frequently isolated germs were Pseudomonas aeruginosa, Klebsiella pneumoniae, and E. coli. The overall mortality rate was 77.2%. Poor prognostic factors included mechanical ventilation, deep coma, and ventilator-associated pneumonia (VAP).
Conclusion: Nosocomial infections most frequently complicated neurological conditions and were predominantly pulmonary. Pseudomonas aeruginosa was the leading causative pathogen. These infections were responsible of high mortality.