[Study of the prevalence of nosocomial infections and associated factors in the two university hospitals of Lubumbashi, Democratic Republic of Congo].
BACKGROUND
To estimate the prevalence "on any given day" of nosocomial infections and to determine their associated factors. Then, to estimate the prevalence of microorganisms responsible for nosocomial infections in Lubumbashi, Democratic Republic of Congo.


METHODS
A descriptive cross-sectional study was conducted in two hospitals in Lubumbashi in five inpatient units (Surgery, Gynecology and Obstetrics, Internal Medicine, Pediatrics and Recovery). The sample consisted of 171 hospitalized patients who were questioned using a standardized questionnaire. Patient's medical record allowed us to know the type of antibiotic administered to the patient 48 hours after admission. Our study was conducted in February 2010 as part of the first local prevalence survey on nosocomial infections.


RESULTS
Our study collected data on 59 patients with nosocomial infection. The overall prevalence was 34.5% (17.0% with acquired nosocomial infection and 17.5% with imported infection). According to the World Health Organization, nosocomial infection is a hospital-acquired infection which was not present or incubating at the time of patient admission. The following risk factors have been associated with acquired nosocomial infections: duration of hospitalization (long stay hospital patients, hospital length of stay of more than seven days has a higher risk than shorter length of stay, hospital length of stay of less than or equal to seven days (prevalence ratio: RP =3.6 [IC A 95%.1.4-8.9])). Among nosocomial infections, surgical site infections were the most common (27.1%), followed by lung infections (22.0%) and urinary tract infections (17.0%). Microbiological examination highlighted five germs responsible for nosocomial infection in infected patients: Escherichia coli (11.9%), Staphylococcus aureus (6.8%), Pseudomonas aeruginosa (5.1%), Shigella spp (5.1%) and Salmonella typhimurium (1.7%). Microbiological examination was performed in 31.0% (n = 59). Cefotaxime, third-generation cephalosporin was the most prescribed antibiotic (37.9%), followed by amoxicillin (19.6%) and ampicillin (16.3%) for monotherapy. Dual and triple therapy was also prescribed. Parenteral route was the most used for anti-infective administration. There was a significant difference in the prevalence of nosocomial infections between the two university hospitals; the prevalence of acquired nosocomial infection was 22.2% in University Clinics of Lubumbashi and 13.1% in Sendwe hospital.


CONCLUSIONS
In our study, the overall prevalence of nosocomial infections was 34.5%. Surgical site infections were the most common (27,1%). Escherichia coli was the most common germ (11.9%).
Ecole de Santé Publique, Université Libre de Bruxelles, Belgique.
Danny Kasongo
DK
Kakupa
Faculté de Médecine, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo.
Prosper Kalenga
PK
Muenze
Ecole de Santé Publique, Université Libre de Bruxelles, Belgique.
Baudouin
B
Byl
Ecole de Santé Publique, Université Libre de Bruxelles, Belgique.
Michèle Dramaix
MD
Wilmet
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
D000900:Anti-Bacterial Agents
Infections nosocomiales; hôpitaux; prévalence