Determinants of Nosocomial Infections Among Hospitalized Patients in Kano, Nigeria: A Logistic Regression Analysis of Prevalence and Risk Factors
Abstract
Nosocomial Infections (NIs) is a major threat to patients’ well-being leading to morbidity and mortality in low-income regions, but updated data from sub-Saharan Africa remain limited. This study was conducted to assess the prevalence, microbial profile, and risk factors of nosocomial infections at Murtala Muhammad Specialist Hospital, Kano, Nigeria. A cross-sectional hospital-based study involving 346 hospitalized patients from surgical, orthopaedic, and eclampsia wards. Urine, wound swabs and blood samples were collected and processed using standard microbiological techniques. Positive isolates were subjected to biochemical tests based on Bergey's Manual of Determinative Bacteriology. A questionnaire was administered to the patients to obtain their demographic information and risk factors associated with NIs. Logistic regression was employed to analyse the risk factors. Overall infection prevalence was 39.9% (138 out of 346), with Gram-positive bacteria (75.4%) mainly Staphylococcus aureus and Streptococcus spp. Proteus, Pseudomonas aeruginosa, Klebsiella pneumoniae and E. coli represented Gram-negatives isolates. Urine has the highest bacterial burden of 55.1%, with Streptococcus species with Streptococcus species being the most common isolate 40 (29.0) 38 especially in urine sample 38 (27.5). Male orthopaedic ward has the highest bacterial burden of 54.7% with Proteus being one of the predominating organisms isolated from wound swab. Major risk factors included the ward of admission (Female Surgical ward: OR = 114.0, p < 0.001) and age above 50 years (OR = 2.63). Low education (OR = 12.28) was also identified as a significant factor. The study reports a high occurrence of NIs at MMSH, the distribution of which driven by structural, clinical, and behavioural factors. Infection Prevention and Control (IPC) programs and patient education are crucial to reduce infection risk especially in high-risk wards.