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Hospital infection high in poor nations
The number of hospital-acquired infections in developing countries is more than three times higher than the rate in the US, and more than double the rate in Europe.
According to the findings published in The Lancet, the infection rate in developing countries is 15.5 per 100 patients, whereas the rate is as low as 7.1 in Europe and 4.5 in the US.
In the intensive care units (ICUs), the condition is reported to be more severe, with 47.9 per 1,000 patient-days in developing countries, compared to 13.6 in the US, World Health Organization (WHO) researchers said.
"Health care-associated infections have long been established as the biggest cause of avoidable harm and unnecessary death in the health systems of high income countries. We now know that the situation in developing countries is even worse," said Benedetta Allegranzi, Technical Lead for the Clean Care is Safer Care program at the WHO and co-author of the study.
"One in three patients having surgery in some settings with limited resources becomes infected. Solutions exist, and the time to act is now. The cost of delay is even more lives tragically lost," WHO officials said.
Researchers believe simple and inexpensive measures such as hand hygiene, surveillance, and staff education could reduce the number of hospital-acquired infections and their related toll in developing countries.
Allegranzi, et al. (2010) report that they conducted a literature search of papers published from 1995 to 2008 and included in their review studies containing full or partial data from developing countries related to infection prevalence or incidence, including overall HAI and major infection sites and their microbiological cause.
The researchers report that of 271 selected articles, 220 were included in the final analysis. Limited data were retrieved from some regions and many countries were not represented. 118 (54 percent) studies were low quality. In general, infection frequencies reported in high-quality studies were greater than those from low-quality studies. Prevalence of HAIs was much higher than proportions reported from Europe and the U.S. Pooled overall HAI density in adult intensive-care units was 47·9 per 1,000 patient-days (95% CI 36·7—59·1), at least three times as high as densities reported from the U.S. Surgical site infection was the leading infection in hospitals (pooled cumulative incidence 5·6 per 100 surgical procedures), strikingly higher than proportions recorded in developed countries. Gram-negative bacilli represented the most common nosocomial isolates. Apart from methicillin resistance, noted in 158 of 290 (54 percent) Staphylococcus aureus isolates (in eight studies), very few articles reported antimicrobial resistance.
The researchers conclude that the burden of HAIs in developing countries is significant and that their findings indicate a need to improve surveillance and infection control practices
