Healthcare-associated infections in the dermatology wards in a University Hospital in Egypt

Background Healthcare-associated infection (HCAI) is a growing problem in healthcare today. Thus, surveillance of HCAI is an important aspect of modern infection control. Objective To identify the incidence, etiology, and outcome of HCAI in the dermatology wards at Cairo University Hospital. Patients and methods In a cross-sectional study, over a period of 3 months, 180 patients were surveyed for HCAI and its risk factors according to the criteria set by the Centers for Disease Control and Prevention. Samples were obtained from skin lesions upon admission and after 72 h. Whenever infection was suspected, samples were obtained from the corresponding site or body fluids and submitted for microbiological evaluation. Results Ten patients out of 180 (5.6%) inpatients developed HCAI: four cases with urinary tract infection, three cases with skin and soft tissue infection, two cases with conjunctivitis, and one with respiratory tract infection. The intravenous cannula was the only medical device used during the study period. Methicillin-resistant Staphylococcus aureus was obtained in 50% of cultures. The nurse-to-patient ratio was 1: 8, the median length of stay of patients who developed HCAI was 40 days. The HCAI mortality was one out of 10 patients, with a 10% rate. This was a 45-year-old male patient with pemphigus vulgaris; methicillin-resistant Staphylococcus aureus growth was only obtained from the conjunctival mucosal surface. Conclusion The present study documents for the first time, to our knowledge, the status of HCAI in an Egyptian University Hospital dermatology inpatient. Prolonged length of stay, progressive disease course, empirical use of antibiotics, and a low nurse-to-patient ratio were the main causes for the development of HCAI. The incidence of HCAI in the dermatology wards (5.6%) appears to be within the reported international levels; however, this value could be reduced by addressing the predisposing factors.