Incidence, Risk Factors, and Mortality From Hospital-Acquired Infections at a Hospital in Mauritius

Abstract

Introduction Hospital-acquired infections can be associated with an increase in morbidity, length of stay, and cost. Data on this topic are very limited in Mauritius. This study seeks to identify (a) the most prevalent hospital-acquired infection locally, (b) the risk factors for acquiring nosocomial infections, and (c) the mortality rate linked to such infections. Methods This is an observational study that was conducted at a 600-bed hospital in Mauritius by going through the folders of 109 patients who were admitted in different wards. Cox regression was used to carry out the survival analysis. Results Over the past 25 years, the incidence of hospital-acquired infections has increased by two to three times in Mauritius to reach a value of 18 per 100 admitted patients. The most commonly identified nosocomial infection was ventilator-associated pneumonia. The presence of foreign devices increased the risk of acquiring nosocomial infections. The mortality rate from such infections was almost four times higher compared to the mortality rate from patients who did not suffer from these infections; however, after adjustment for potential confounders, this was not statistically significant. The incidence of ventilator-associated pneumonia and central line-associated bloodstream infections was high at 46 per 1,000 ventilator-days and 25 per 1,000 central line days, respectively. Conclusion Infection prevention and control measures should be implemented to curtail the rise of hospital-acquired infections in Mauritius. Such measures should include the use of bundles of care. In addition, periodic surveillance of nosocomial infections needs to be encouraged.

Keywords: central line-associated bloodstream infections; hospital-acquired infections; nosocomial; surgical site infections; ventilator-associated pneumonia.

Figure 1. Flow diagram illustrating how patients were selected in the study.

Figure 2. The Kaplan-Meier curve demonstrating the survival of patients with and without hospital-acquired infections.

Figure 3. Pie chart classifying the frequency of each HAI that was identified in the study. VAP, CLABSI, and SSI were the most common types of HAIs, while primary bloodstream infections and vascular site infections were the rarest.

CLABSI, central line-associated bloodstream infections; HAI, hospital-acquired infections; SSI, surgical site infection; VAP, ventilator-associated pneumonia

Figure 4. The Kaplan-Meier curve illustrating the risk of developing VAP after being intubated. By 18 days, only 17% of intubated patients did not develop a VAP yet.

VAP, ventilator-associated pneumonia