Prevalence of Healthcare-Associated Infections in a Tertiary Hospital in Casablanca, Morocco, 2021

TL;DR

This study found a 9.7% healthcare-associated infection rate in a Moroccan hospital, with high rates in intensive care units and drug-resistant bacteria causing concern.

Contribution

The study provides new data on HAI prevalence and risk factors in a Moroccan hospital during the pandemic, highlighting imipenem-resistant Acinetobacter baumannii as a critical issue.

Findings

HAI prevalence was 9.7% with the highest rate in intensive care units (44.2%).

Nosocomial pneumonia was the most common infection site (26.8%).

Imipenem-resistant Acinetobacter baumannii was prevalent and significantly associated with HAIs.

Abstract

Background: During the COVID-19 pandemic, healthcare professionals experienced an increased workload, which may have affected infection prevention and control (IPC) programs and consequently healthcare-associated infection (HAI) rates. The objective of this study was to estimate the prevalence of HAI in Ibn Rochd University Hospital Center (IRUHC) and identify associated factors.

Methods: A survey was conducted on November 30, 2021 at IRUHC, including all patients hospitalized for at least 48 hours. Data was collected using a questionnaire, and analyzed using SPSS IBM software version 16. The significance level was set at 0.05.

Results: Among 887 patients, the prevalence of HAI was 9.7% (7.7%; 11.6%). The highest prevalence was observed in intensive care units (ICUs) (44.2%). Nosocomial pneumonia was the most common site (26.8%). The main isolated microorganisms were Acinetobacter baumannii (18.0%) and Escherichia coli (16.0%). All Acinetobacter baumannii isolated strains were imipenem-resistant. The presence of HAI was significantly associated with the presence of an invasive medical device (p<0.001), a higher physical status score of American Society of Anesthesiologists (ASA) (p<0.001), and a longer hospital stay (p<0.001).

Conclusion : The emergence of imipenem-resistant Acinetobacter baumannii (IRAB) represents a serious therapeutic and epidemiological problem requiring the establishment of a system for monitoring the microbial environment and the application of strict hygiene measures.