Abstract
Introduction: Healthcare-associated infections (HAIs) are an ongoing issue for health systems around the world, with the burden of HAIs highest in low- and middle-income countries, where infection prevention resources are more limited. Pakistan’s public hospitals often face very high patient loads, overcrowding and resource shortages that place patients at an increased risk of developing nosocomial infections.
Purpose: The purpose of this study was to determine the incidence, risk factors and prevention barriers to HAIs in tertiary public hospitals in Islamabad and Rawalpindi.
Methods: A prospective cohort study was conducted in three tertiary public hospitals: the Pakistan Institute of Medical Sciences (PIMS), Holy Family Hospital – Rawalpindi, and Benazir Bhutto Hospital – Rawalpindi. The cohort consisted of 600 adult patients admitted to either medical or surgical wards who were followed for the development of healthcare-associated infections during their hospitalisation from January 2023 to June 2023. Patients with infections at the time of admission were excluded. Data were collected by means of structured questionnaires, clinical evaluations and medical record reviews. Multivariable logistic regression analysis was used to identify significant predictors of HAIs.
Findings: The overall incidence of healthcare-associated infections was 14.5%. Of these, the highest percentage (38%) was due to surgical site infections, followed by urinary tract infections (27%), hospital-acquired pneumonia (21%), and bloodstream infections (14%). Independent risk factors for HAI included a longer length of stay (>7 days), use of invasive medical devices, and admission to intensive care unit.