title: Endemic nosocomial infections and misuse of antibiotics in a maternity hospital in Saudi Arabia.
abstract: Patients admitted during a 6-month period to a maternity hospital in Saudi Arabia were studied for nosocomial infections and misuse of antibiotics. Patient history and diagnosis on admission and subsequent clinical and laboratory data were analysed. Infection developing from 72 h after admission was considered nosocomial. Therapeutic and prophylactic data as recorded on the patients' charts were assessed for possible misuse of antibiotics. Of 3439 patients, 136 (4.0%) developed nosocomial infection: 2.0%, 8.9% and 37.7% in obstetric, gynaecologic and nursery patients, respectively. Infections among adults were mostly found in the urinary (44.4%) and lower genital (33.3%) tracts. Among newborns, over 70% of cases were eye and ear (29.8%), skin (26.2%) and blood (19.0%) infections. Gram-negative bacteria caused 65.7% of the infections. Over 90% of the bacterial isolates were multidrug-resistant. About 24% of patients received single or multiple antibiotics; 57.2% were misused. The minimal hospital cost estimate for both nosocomial infections and misused antibiotics was US $318,705. The findings of this study, the first of its type in this region, should prompt improved infection control measures as well as educational and antibiotic restriction interventions.
authors.affiliation: Department of Clinical Microbiology and Parasitology, College of Medicine and Medical Sciences, King Khalid University, Abha, Saudi Arabia.
authors.forename: Naser Eldin
authors.initials: NE
authors.lastname: Bilal
authors.forename: Messele
authors.initials: M
authors.lastname: Gedebou
authors.forename: Saleh
authors.initials: S
authors.lastname: Al-Ghamdi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D004427:Ear Diseases / Q000188:drug therapy; D019353:Endemic Diseases / Q000191:economics; D015817:Eye Infections / Q000188:drug therapy; D005260:Female; D052776:Female Urogenital Diseases / Q000188:drug therapy; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D008508:Medication Errors / Q000191:economics; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012529:Saudi Arabia; D012874:Skin Diseases, Infectious / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents