Neonatal healthcare-associated infections and related factors in three selected teaching hospital in Rwanda

Abstract

Background: Nosocomial infection (NI), also known as Healthcare acquired infection (HCAI), is an infection (s) acquired during the process of receiving health care. Nosocomialinfections are a substantial source of morbidity and mortality, as well as the duration of hospital stay and financial burden on patients, families, and healthcare systems around the world. However, there is limited information about HCAI among neonates in Rwanda. Objectives: The study aims to assess Neonatal Nosocomial Infections and related factors in selected three teaching hospitals in Rwanda. Methodology: A retrospective cross-sectional design was used. A sample size of 273 neonatal files was selected using a stratified simple random sampling method within the three study sites (RMH, KFH, CHUK). The researcher used data abstraction sheet in data collection and used descriptive and inferential statistics in analysis. Results: A total of 273 neonatal files were reviewed. Significant factors associated with neonatal HCAIs included maternal blood group AB (OR=2.365: 95%CI=1.097-5.098; p=0.028), and O group (OR=3.097: 95%CI=1.321-7.262; p=0.009). A neonate with a weight of 3.6kg and above was less likely to have an HCAI (OR=0.094 95%CI=0.016-0.541; p value=0.008) than an infant weighing less than 1.5kg. A neonate born at CHUK was four times more likely to have an HCAI (OR=4.072: 95%CI=1.054-15.724; p=0.042), than a neonate born at KFH. Neonatal death was three times more likely to be associated with HCAI (OR=3.337:95%CI=0.996-11.186; p value=0.051). The main neonatal HCAIs were Klebsiella pneumonia, Staphylococcus aureus, and Candida albicans while the most predominant neonatal HCAIs we klebsiella pneumonia bacteria affecting 142(52%) of participants, and 80 (29.3%) died due to HCAIs. Conclusion: This study showed that preterm, low birth weight, neonatal death, and maternal blood type were associated with HCAIs at the three study sites and the most predominant HCAI was Klebsiella pneumonia. Hence, understanding the risk factors associated with HCAIs is crucial to help reduce neonatal morbidity and mortality, related cost of care, and apotential increase in antibiotic resistance in clinical settings.