Healthcare associated infection risk analysis at the obstetrics and gynecology department of a referral hospital in Cameroon
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Background
Healthcare-associated infections (HAIs) are a major problem in healthcare facilities. In Cameroon, maternal and neonatal mortality remain a concern. The underlying determinants include shortcomings in the quality of care, inadequate infrastructure and inconsistent application of infection control and prevention (ICP) measures. The objective of this study was to identify risks that increase the likelihood of HAIs in the obstetrics-gynecology unit of a referral hospital of Yaoundé.
Methods
A descriptive cross-sectional study was conducted in the obstetrics-gynecology department of referral hospital of Yaoundé from April to July 2024. Exposure data were collected using a self-administered questionnaire with a scoring grid to assess the level of implementation of the ICP framework. Samples were collected from the ward environment for identification of the bacterial flora of the care environment and antibiotic susceptibility testing.
Results
A total of 41 healthcare workers were enrolled in the study. Participants were predominantly female (78%) and aged 20 to 57 (median of 30) years. Hand hygiene knowledge of was average, with a median score of 60%. More than two-thirds of respondents (n=30; 73%) reported that they did not systematically practice hand hygiene before and after patient care. The most common reason for not practicing hand hygiene was the absence of a hand-washing site nearby healthcare post (57%). Face shields were the most reported unavailable equipment (81%). The overall score indicated that the obstetrics-gynecology department had a basic level of implementation of ICP interventions. Microbial analysis revealed that taps and trolleys were the most commonly soiled equipment, harboring bacterial flora of Staphylococcus aureus (36%) and other Staphylococcus spp. (24%). Proteus mirabilis (13%) and Klebsiella spp. (7%). The isolated bacterial strains showed varying degrees of resistance to antibiotics, including cephalosporin, methicillin and penicillin.
Conclusions
Suboptimal IPC implementation was observed in this obstetrics-gynecology setting. Comprehensive interventions are needed, including: strengthened IPC adherence, national antibiotic regulation, healthcare worker education, and establishment of antimicrobial resistance surveillance programs.
