title: Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012.
abstract: BACKGROUND
  Data on nosocomial infections in hospitals in low-income countries are scarce and often inconsistent. The objectives of this study were to estimate the prevalence of nosocomial infections and antimicrobial drug use in Benin hospitals.
  
  
  METHODS
  All hospitals were invited to participate in the first national point prevalence study conducted between 10-26 October 2012 using the protocol developed by the "Hospitals in Europe Link for Infection Control through Surveillance" (HELICS) project. Infection prevalence rates and the proportion of infected patients and exposure to antimicrobials were assessed.
  
  
  RESULTS
  Overall, 87% (39/45) of hospitals participated. Of 3130 inpatients surveyed, 972 nosocomial infections were identified among 597 patients, representing an overall prevalence of infected patients of 19.1%. The most frequent infections were related to the urinary tract (48.2%), vascular catheter use (34.7%), and surgical site (24.7%). 64.6% of patients surveyed were treated with antibiotics, including a significant proportion (30%) of non-infected patients and a high proportion of self-medication (40.8%). Resistance of leading nosocomial pathogens to antimicrobials included methicillin-resistance (52.5%) among Staphylococcus aureus, vancomycin resistance among enterococci (67.5%), cefotaxime resistance among Escherichia coli (67.6%), and ceftazidime resistance among Acinetobacter baumannii (100%) and Pseudomonas aeruginosa (68.2%).
  
  
  CONCLUSIONS
  Benin has high nosocomial infection rates and calls for the implementation of new national infection control policies. Patient safety education and training of all individuals involved in healthcare delivery will be critical to highlight awareness of the burden of disease. The high use of antimicrobials needs to be addressed, particularly their indiscriminate use in non-infected patients.
authors.affiliation: Génie de Biologie Humaine, Ecole Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin.
authors.forename: Théodora Angèle
authors.initials: TA
authors.lastname: Ahoyo
authors.affiliation: Génie de Biologie Humaine, Ecole Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin.
authors.forename: Honoré Sourou
authors.initials: HS
authors.lastname: Bankolé
authors.affiliation: International Network for Planning and Improving Quality and Safety in Health Systems in Africa (Réseau International pour la Planification et l'Amélioration de la Qualité et la Sécurité dans les établissements humains en Afrique), Abidjan, Ivory Coast.
authors.forename: Franck Mansour
authors.initials: FM
authors.lastname: Adéoti
authors.affiliation: Improvement Quality Service, Ministry of Health, Cotonou, Benin.
authors.forename: Aimé Attolou
authors.initials: AA
authors.lastname: Gbohoun
authors.affiliation: Improvement Quality Service, Ministry of Health, Cotonou, Benin.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Assavèdo
authors.affiliation: Improvement Quality Service, Ministry of Health, Cotonou, Benin.
authors.forename: Marcellin
authors.initials: M
authors.lastname: Amoussou-Guénou
authors.affiliation: Ministry of Health and Faculty of Medicine, University of Abomey-Calavi, Cotonou, Benin.
authors.forename: Dorothée Akoko
authors.initials: DA
authors.lastname: Kindé-Gazard
authors.affiliation: Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
keywords: Africa; Antibiotic use; Antimicrobial resistance; Co-morbidity; Infection control; Low-/middle-income countries; National surveillance; Nosocomial infection; Prevalence; Surveillance