High burden of nosocomial infections caused by multi-drug resistant pathogen in pediatric patients at Hawassa University Comprehensive Specialized Hospital


  • Tsegaye Alemayehu
  • Endale Tadesse
  • Sosina Ayalew
  • Biruk Yeshitila
  • Bezaye Nigusse
  • Anteneh Amsalu


Background: Pediatric patients are at increased risk of nosocomial infections (NIs) with multi-drugresistant (MDR) pathogens, which are more prevalent in the hospital environment.  The aim of this study was to determine the prevalence of NIs, antibiotic resistance pattern of bacterial isolates and associated factors in pediatric patients at Hawassa University Comprehensive Specialized Hospital.

Methods: A cross sectional study was conducted from March to August, 2016. Socio-demographic and clinical data were collected among patients clinically suspected of developing NI using a structured questionnaire. Bacterial identification and antimicrobial susceptibility test were done with standard microbiological methods. Data were analyzed with SPSS version 20 and p value < 0.05 was considered as statistically significant. 

Conclusion: The high prevalence of NIs with MDR bacteria suggests the need for proper implementation of the NI prevention and control measures.

Keywords: Nosocomial infection, multi-drugresistance, pediatrics, Ethiopia


Pourakbari B, Rezaizadeh G, Mahmoudi S, Mamishi S: Epidemiology of nosocomial infections in pediatric patients in an Iranian referral hospital. J prev med hyg 2012; 53:204-206.

Worku W, Kumie A, Moges F: Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia. Drug Healthc Patient Saf 2016; 8 71-76.

Bereket W, Hemalatha K, Getenet B et al: Update on bacterial nosocomial infections. Eur Rev Med Pharmacol Sci 2012; 16(8):1039-1044.

Balaban İ, Tanır G, Timur Ö et al. Nosocomial infections in the general pediatric wards of a hospital in Turkey. Japanese j infect dis 2012; 65(4):318-321.

Becerra M, Tantaleán J, Suárez V, Alvarado M, Candela J, Urcia F. Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC pediatrics 2010; 10(1):66.

Mikyas D, Sileshi L. The prevalence of nosocomial infections and associated risk factors in pediatric patients in Tikur Anbessa Hospital. EthiJ PCH 2009; 5(5):1-4.

Mulu W, Kibru G, Beyene G, Damtie M. Postoperative nosocomial infections and antimicrobial resistance pattern of bacteria isolates among patients admitted at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia. EJHS 2012; 22(1):7-18.

Solomon F, Wadilo F, Arota A, Abraham Y. Antibiotic resistant airborne bacteria and their multidrug resistance pattern at University teaching referral Hospital in South Ethiopia. Ann Clin Microbiol Antimicrob 2017; 16(1):29.

Meropol S, Haupt A, Debanne S. Incidence and Outcomes of Infections Caused by Multidrug-Resistant Enterobacteriaceae in Children, 2007- 2015. J Pediatric Infect Dis Soc 2017: piw093.

McFee RB. Nosocomial or hospital-acquired infections: an overview. Dis Mon 2009; 55:422-438.

Endalafer N, Gebre-Selassie S, Kotiso B: Nosocomial bacterial infections in a tertiary hospital in Ethiopia. J. Infect. Prev. 2011; 12(1):38-43.

Cheesbrough M: District laboratory practice in tropical countries volume II. Microbiology Cambridge (UK) Cambridge University Press. 2006.

Bayer A, Kirby W, Sherris J, Turck M: Antibiotic susceptibility testing by a standardized single disc method. Am J clin pathol 1966; 45(4):493-496.

CLSI: Performance standards for antimicrobial susceptibility testing; twenty-second information supplement. CLSI document M100-S22. Wayne, PA: Clinical and Laboratory Standards Institute. 2016.

Magiorakos A, Srinivasan A, Carey R et al: Multidrug‐resistant, extensively drug‐resistant and pandrug‐resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. CMI 2012; 18(3):268-281.

Kasim K, El Sadak A-A, Zayed K, Abdel-Wahed A, Mosaad M: Nosocomial infections in a neonatal intensive care unit. Middle East J Sci Res 2014; 19:1-7.

Greco D, Magombe I: Hospital acquired infections in a large north Ugandan hospital. JPMH 2011; 52(2).

Aktar F, Tekin R, GüneG A et al. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients. BioMed Research International 2016, 2016:http://dx.doi.org/10.1155/2016/7240864.

Agus D, Linde-Zwirble W, Lidicker J, Pinsky M. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated cost of care. Critic Car Med 2001; 29:1303-1310.

Porto J, Mantese O, Arantes A, Freitas C, Gontijo F, Ribas R. Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance. Rev Soc Bras Med Trop 2012; 45 (4):475-479.

Worku W, Abera K, Moges F: Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: A matched-case control study. PloS one 2017; 12(7): e0181145.

Ašembergienė J, Gurskis V, Kėvalas R, Valintėlienė R: Nosocomial infections in the pediatric intensive care units in Lithuania. Medicina (Kaunas) 2009; 45(1):29-36.

Abramczyk M, Carvalho W, Carvalho E, Medeiros E. Nosocomial infection in a pediatric intensive care unit in a developing country. J Prev Med Hyg 2003; 7(6):375-380.

Santajit S, Indrawattana N: Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. BioMed Research International 2016.

CDC: Klebsiella pneumoniae in Healthcare Settings. In August; 2012.

Das R, Chandrashekhar T, Joshi H, Shrestha N, Shivananda P. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore Med J 2006; 47(4):281.

Cervera C, Almela M, Martínez-Martínez J, Moreno A, Miró J. Risk factors and management of Gram-positive bacteraemia. Int. J. Antimicrob. Agents 2009; 34:S26-S30.

Eshetie S, Tarekegn F, Moges F, Amsalu A, Birhan W, Huruy K: Methicillin resistant Staphylococcus aureus in Ethiopia: a meta-analysis. BMC infectious diseases 2016; 16(1):689.

Ahoyo T, Bankolé H, Adéoti F et al. Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. Antimicrob Resist Infect Control 2014; 3(1):17.

Caini S, Hajdu A, Kurcz A, Borocz K. Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010. Euro Surveill 2013; 18(2):20352.

Cornejo-Juárez P, Vilar-Compte D, Pérez-Jiménez C, Namendys-Silva S, Sandoval-Hernández S, Volkow-Fernández P; The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit. IJID 2015; 31:31-34.

Lee C, Yeh S, Lim H, Liu C, Tseng H: High prevalence rate of multidrug resistance among nosocomial pathogens in the respiratory care center of a tertiary hospital. J micro, immuno, and infection 2009; 42(5):401-404.

Sritippayawan S, Sri-Singh K, Prapphal N, Samransamruajkit R, Deerojanawong J: Multidrug-resistant hospital-associated infections in a pediatric intensive care unit: a cross-sectional survey in a Thai university hospital. IJID 2009; 13(4):506-512.

Parajuli N, Acharya S, Mishra S, Parajuli K, Rijal B, Pokhrel B. High burden of antimicrobial resistance among gram negative bacteria causing healthcare associated infections in a critical care unit of Nepal. Antimicrob Resist Infect Control 2017; 6(1):67.






Original Article