Epidemiological manifestations and burden of healthcare-associated infections in Libyan national hospitals

Abstract

Background Healthcare-associated infection is a serious global problem, particularly within developing countries. In Northern African countries comprehensive research on the prevalence and effects of such infections was rarely carried out. The objectives of this study were aimed to evaluate the epidemiology and determine the burden of healthcare-associated infections in Libyan national teaching hospitals. Methods A prospective longitudinal study was carried out in the four largest teaching and referral hospitals in Libya including Tripoli Medical Centre, Tripoli-Central Hospital, Benghazi Medical Centre, and Sebha Medical Centre within a year from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Centre for disease control. The surveillance analysis was carried out on all patients admitted to medical wards, surgical, ICU, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed medical records and the percentages of patients with health care–associated infections were compared. Bio-statistical and multivariable logistic regression analyses were carried out to test variables associated with HAI events and the resulting deaths. Results A total of 22170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported among 3037 patients with an overall prevalence of 13.7% (95% CI:12.9%- 14.4%). Interestingly the prevalence varied among the hospitals studied. The highest was reported in Benghazi Medical Centre reported (17.9 % (95% CI:16.9%- 18.71%), followed by Sebha Medical Centre (14.8% (95% CI:14.5.9%- 16.51%). Surgical site infection was the highest (31.28 %), followed by Ventilator-associated pneumonia (29.34 %), urinary tract infections (26.84 %), and Bloodstream infection (12.55 %). Patients with HAIs experienced severe morbidity that required intervention. New antimicrobial regimens were needed for 1836(93 %) patients and 752(34 %) required ICU admission. In addition to surgical intervention, respiratory support, and inotropes were needed as a consequence of HAI events. Conclusions The prevalence of Healthcare-associated infection in Libyan hospitals was found to be high and it should be considered a major problem with a serious burden. Hospital management should be alerted, indicating an urgent need to intervene at the national and hospital levels to implement preventive and control strategies to combat HAI.