Multidrug Resistant Organism Surveillance Project: Assessing patient and healthcare providers’ attitudes; knowledge or beliefs regarding multidrug resistant organism infection, surveillance and infections control practices at CHUK, Kigali.

Abstract

Background: Nosocomial infections caused by multi-drug resistant organisms (MDRO) contribute significantly to mortality and prolonged length of stay among hospitalized patients. A significant proportion of MDRO infections are transmitted between patients via healthcare workers typically in setting of poor hand hygiene practices. Methicillin resistant staph aureus (MRSA) and extended-spectrum beta-lactamase producing (ESBL) organisms are recognized as some of the principal pathogens that are easily transmitted in healthcare settings. OBJECTIVES: This study aimed to assess patient and healthcare providers‘ attitudes, knowledge and/or beliefs around MDRO surveillance and infection control practices at CHUK, Kigali. METHODOLOGY: Questionnaires were administered to both healthcare providers as well as patients hospitalized on various departments or units (Pediatrics, Gynecology-Obstetrics, Intensive Care Unit, Emergency Department, Ear, Nose and Throat, Internal Medicine and Surgery) at CHUK hospital. Healthcare providers self-administered their own questionnaires while patient respondents were guided on how to fill them by study investigators. Simple descriptive statistics were used to report study findings for each surveyed category (patients or healthcare providers). Chi square test was used to compare response frequencies between patients and healthcare providers with statistical significance set at p<0.05. RESULTS: Overall, 250 healthcare providers and 245 patients completed the survey. The study found that while 128/250 (51.2%) of health care workers (HCWs) had limited knowledge about MDROs, there was a significantly limited knowledge about them among surveyed patients (P<0.05). While 236 HCWs (94.4%) agree with the use of soap and water as being appropriate for hand hygiene, only 174 (69.6%) HCWs reported that they routinely wash their hands after handling patients. Overall, majority of patients (64.9%) were not satisfied with HCWs hand hygiene practices. vi Regarding surveillance procedures, 71 patients (29%) reported discomfort with accepting rectal swabs as a modality for screening for colonization with ESBL producing organisms and 74% of HCWs still believe that beta-lactam antibiotics (penicillins and cephalosporins) can be used for their treatment. CONCLUSION This study showed limited knowledge by both patients and healthcare providers regarding nosocomial infections caused by MRSA and ESBL producing organisms. These knowledge gaps about MDROs and their surveillance are concerning and should inform future efforts to educate patients and their providers about this public health problem.