The magnitude of nosocomial infections among intensive care unit patients at Muhimbili medical centre, Dar es Salaam, Tanzania.

Abstract

The determination of the prevalence of nosocomial infections, associated risk factors, and the antimicrobial susceptibility pattern of bacterial isolates among patients admitted to the intensive care uni t was carried out. Critically ill patients admitted to the intensive care unit, medical staff and equipment were evaluated, samples were taken for gram staining, culture and the determination of antimicrobial susceptibility pattern of bacterial isolates. Of the two hundred and sixty two patients admitted during the study period, 200 were recruited into the study; they comprised of 179 (68.3%) males and 83 (3l. 7%) females. Head injured patients accounted for 15.5% of the total admissions, followed by tetanus (12.0%), post craniotomy, cerebral tumors, dental conditions, septicemia, ruptured viscera and burn patients made up the rest of

the admitted patients.

lCU equipment were found to harbor

pathogenic organisms, medical staff working in the lCU were also found to harbor pathogenic which could infect patients in the lCU (p=0.007). '\ --- ~- - --- "- ~-. -~~-- -- VIII Pneumonia afflicted 62.5% of patients and the leading pathogen was Klebsiella spp (38.4%), ventilator associated pneumonia was seen in 57.6% of patients. Urinary tract infection was diagnosed in 90% of patients, and the leading pathogen isolated was Klebsiella , , spp (36.7%). Pseudomonas aeruginosa was isolated in 15.0% and 36.4% patients with bacteremia and surgical wound infections,

respectively. determined.

Their antimicrobial susceptibility pattern were Means for prevention and control of nosocomial

infections are suggested. Nosocomial infections are significantly prevalent m patients admitted to the Intensive care unit. Gram-negative organisms are the leading pathogens in these conditions. Equipment and medical staff in the Intensive Care unit harbor certain infectious micro- orgamsms which could infect patients admitted therein. In the absence of working surveillance system in place, nosocomial infections will continue to be a major factor in the increased

morbidity and mortality for patients admitted.

As bacteria

resistance to antimicrobials is a potential problem in the ICU, means must be put in place to effect continuous surveillance of antimicrobial resistance.