Nosocomial Infections at Three Regional Tertiary Hospitals in Trinidad and Tobago

Abstract

Objective: The main objectives of this research were to conduct and provide accurate and original findings related to the epidemiological study of nosocomial infections at three regional tertiary hospitals in Trinidad and Tobago. Specifically, the researcher determined; the frequency of nosocomial infections (NI), the frequency of multiple drug resistance among bacterial organisms associated with NI, infection control measures practiced at the research hospitals and the cost of such NI in terms of morbidity and mortality Synopsis: This study estimated the rate of nosocomial infections (NI) among patients at three major regional hospitals in Trinidad and Tobago and evaluated the frequency of pathogens associated with nosocomial infections. Approximately 450 of 126, 668 patients had nosocomial infections and the most frequent type of nosocomial pathogens were: Staphylococcus sp. (22.5%), Pseudomonas aeruginosa sp. (12.7%), Acinetobacter (11.8%) and Klebsiella sp. (11.6%). Methods: A one-year prospective cross-sectional study was carried out. The nosocomial pathogens were retrieved from the microbiology laboratory. Antimicrobial susceptibility test by the disk diffusion method were done on all bacterial isolates. Data was analysed using SPSS version 20.0. Results: This research revealed that 450 inpatients suffered nosocomial infections, with thirty (30) mortalities during the twelve (12) months that the study lasted (June 2013 to May 2014) at three regional hospitals of Trinidad and Tobago. The incidence of nosocomial infections was 5.8% and the nosocomial infection rate was 3.6 per 1000 (450/126,668). The highest rate (30.1%) was observed in the Intensive Care Unit (82/272 admissions). The most frequent type of nosocomial infection was Skin and Soft Tissue Infections 168 (37.3%). Staphylococcus sp. (22.5%), Pseudomonas aeruginosa sp. (12.7%), Acinetobacter (11.8%) and Klebsiella sp. (11.6%) were the most frequently occurring nosocomial pathogens. Conclusion: Consistency in performing good hygiene practices is vital for reducing the high nosocomial rate found at the research sites. Prediction of these infections is very important as a part of clinical surveillance programs to take preventive measures in advance. The antimicrobial susceptibility pattern rate (ASPR) showed that only 8.3 % (5/60) of the isolates were antibiotic-susceptible strains.