[Factors affecting nosocomial infection in the surgery setting at the Hospital of Point "G"].
Nosocomial infections are a common and increasing problem globally, and particularly in Africa. The significant economic burden of these infections on the health care system as well as their impact on patient morbidity and mortality is well recognised within the medical communities.The goal of this study was to investigate factors that influence nosocomial infection in all in-patients from the surgery wards (surgery ward A and B, Gynoeco-obstetrics, urology and intensive care) at the national hospital of Point G in Bamako, Mali. We report the number of nosocomial infection during a prospective study between June 2003 and January 2004. Of 1043 in-patients, 102 had had a nosocomial infection with a global prevalence of 9.7% (8.0-11.4). Of 1024 patients with surgery, 101 had had a nosocomial infection, a post-surgery nosocomial infection rate of 9.8% (8.1-11.5). We observed different site of nosocomial infection such as suppuration sup-aponevrotics (41.2%), parietal infection sub-aponevrotics (32.4%), urinary infection (17.6%) and organ suppuration (3.9%). Other nosocomial infection observed were pneumonia (2.9%) and catheterisation (2.0%). The nosocomial infection rate was 10.3% in male while it was 7.3% in female. The difference between male and female was not statistically significative (chi2 = 2.33, p = 0.12). Nosocomial infection was more prevalent in patients after emergency surgery (15.1%) than in scheduled surgery patients (8.5%) (chi2 = 8.15, p = 0.004). The classes III and IV of ALTEMEIER had the higher proportion of nosocomial infection (35.9%) against 4.8% for the classes I and II (chi2 = 144.95, p < 0.001). The patients with ASA score I had a lower nosocomial infection rate than patients from the intensive care unit or patients of Class II + III + IV (chi2 = 13.2, p = 0.001). Patients classified according to the National Nosocomial Infection Surveillance System (NNISS) with a score 0 had a nosocomial infection rate less than patients classified as NNISS score 1, 2 or 3 (chi2 = 82.0, p < 0.001). The study results underline the need for further investigations of the role of microbial agents and antimicrobial resistance in the outcome of patients with nosocomial infection.
Koumare
A K
AK
Hôpital du Point G service de chirurgie B.
Sissoko
F
F
Diop
A K T
AK
Ongoiba
N
N
Maiga
I
I
Bougoudogo
F
F
Soumare
S
S
Sangare
D
D
Ouattara
K
K
Diallo
A
A
Doumbia
D
D
Dembele
S
S
D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008302:Mali; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors