title: Incidence, pathogens and resistance patterns of nosocomial infections at a rural hospital in Gabon.
abstract: BACKGROUND
  Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambaréné, Gabon.
  
  
  METHODS
  This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections.
  
  
  RESULTS
  A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms.
  
  
  CONCLUSIONS
  The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.
authors.forename: Micha
authors.initials: M
authors.lastname: Scherbaum
authors.forename: Katrin
authors.initials: K
authors.lastname: Kösters
authors.forename: Raymund Egid
authors.initials: RE
authors.lastname: Mürbeth
authors.forename: Ulysse Ateba
authors.initials: UA
authors.lastname: Ngoa
authors.forename: Peter Gottfried
authors.initials: PG
authors.lastname: Kremsner
authors.affiliation: Centre de Recherches Medicales de Lambarene, Albert Schweitzer Hospital, PB 118 Lambaréné, Gabon. bertrand.lell@uni-tuebingen.de.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lell
authors.forename: Abraham
authors.initials: A
authors.lastname: Alabi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents