Prevalence, antimicrobial resistance patterns and risk factors to Enterobacteriaceae nosocomial infections among in-patients at Univic Medical Centre – Victoria Hospital, Kampala

Abstract

Nosocomial infections caused by Enterobacteriaceae are a major concern in hospital settings due to their high prevalence and antimicrobial resistance. This study assessed the prevalence, distribution, antimicrobial resistance patterns, and risk factors associated with Enterobacteriaceae nosocomial infections among patients at UMC Victoria Hospital. A retrospective study was conducted by reviewing patients records of patients admitted at UMC Victoria hospital from January 2020 to December 2023 involving 250 patients records for patients admitted to the hospital. Sociodemographic, clinical characteristics, and hospital procedures were recorded. Microbiological testing performed to identify Enterobacteriaceae isolates, and antimicrobial susceptibility testing carried out on the isolates, using the VITEK 2 machine was captured. Risk factors to infection were analyzed using incidence rate ratios (OR). Of the 250 patients, 139 (55.6%) tested positive for Enterobacteriaceae. The most common isolates were Escherichia coli (61.9%), followed by Klebsiella spp (20.1%) and Citrobacter spp (10.8%). The highest antimicrobial resistance was observed towards Ampicillin (92%), followed by Tetracycline (90%), and Trimethoprim-Sulfamethoxazole (74%). Significant risk factors to Enterobacteriaceae infections included invasive procedures (OR = 1.62, p = 0.040), surgical ward admissions (OR = 20.41, p = 0.030), and hypertension (OR = 1.93, p = 0.015). Prolonged hospital stays (>4 weeks) were also associated with an increased likelihood of infection (p = 0.04). Enterobacteriaceae infections are prevalent at UMC Victoria Hospital, with high resistance rates to common antibiotics notably Ampicillin, Tetracycline, and Trimethoprimsulfamethoxazole. Invasive procedures, prolonged hospital stays, and comorbidities such as hypertension were significant risk factors to infection. These findings highlight the need for improved infection control practices and antimicrobial stewardship to address the growing challenge of nosocomial infections and antimicrobial resistance