The extent of hospital-associated infections (HAIs) in low-income settings remains largely unknown and underestimated. Our aim is to describe the burden of HAIs associated with hospitalization in neonatal intensive care units (NICUs) in Sidama Region, Ethiopia. We performed a retrospective cohort study at the NICUs of four purposely selected public hospitals among 5216 neonates admitted over 5 years period (2017-2022). Neonatal surveillance registers were reviewed and patients' characteristics, HAIs incidence, risk factors and outcomes of infections were recorded. Bayesian logistic regression analyses were used to control potential confounders. Among 5216 neonates (52,514 observed patient days), 2079 cases of HAI were observed (40%), equivalent to 39.59 per 1000 patient-days. The neonatal mortality rate was 105 deaths per 1000 live births. Over the five-year period, the infection rate decreased overall. Risk factors for HAIs were hospital type, place of delivery, antibiotic treatment and low birth weight babies 2000g-<2500g. We found a high incidence of HAIs in NICUs, and HAIs related deaths were unexpectedly high. Hospital type, place of birth, birth weight and in appropriate use of antibiotic treatment were risk factors for HAIs. Emphasis should be given to reduce inappropriate antibiotic use and focus on risk factors.
Haji et al. (Tue,) studied this question.