Hospital acquired blood stream infections: epidemiology, risk factors, & infection control measures

Marah El Beeli


B ackground: Hospital acquired bloodstream infections (HA-BSIs) are one of the most serious hospital acquired infections. Surveys have shown that HA-BSIs were responsible for 20%-60% of hospitalization related deaths. Despite the high morbidity and fatality, and enormous burden of health care costs of HA-BSIs, to our knowledge, there are no published studies on HA-BSI in the Middle East. This study is an attempt to enhance the knowledge about HA-BSI and to advance scientific knowledge and improve services in Oman hospitals. Objectives: This study aims to 1) Estimate the prevalence of HA-BSI in Oman, 2) Evaluate the risk factors profile of occurrence of HA-BSI in Oman, 3) Assess the knowledge, attitude, and practice (KAP) among healthcare providers towards infection control strategies related to HA-BSI in Oman. Methods: This research is including four studies. The first study is ‘Prevalence of HA-BSIs in a Tertiary Hospital in Oman’. It is a cross-sectional study ambi-directional (retrospective & prospective) follow up. The study will retrieve data on hospital acquired infections from the infection control surveillance database at Sultan Qaboos University Hospital (SQUH). The prevalence rate of patients with HA-BSIs and the prevalence rate of HA-BSI isolates (HA-BSI events) will be calculated by dividing the number of cases with index by number of monthly inpatient admissions for the whole year. The prevalence rates will be reported per 1,000 admissions. The second study is ‘Risk factors profile of occurrence of HA-BSIs’. It is a case-control study will be conducted to compare between HA-BSI cases and matched non-HA-BSI controls. HA-BSI Cases will be recruited from the registry to be established in study-1. Suitable controls will be recruited using Risk set sampling technique. Controls will be matched to the cases based on important confounding factors. The third study is ‘Knowledge, Attitude, and Practice among Healthcare Providers towards Infection Control Strategies related to HA-BSIs”. It is a Cross-sectional study. A random sample of healthcare providers among medical, nursing, and technical staff working at SQUH, will be enrolled  using clustered random selection scheme. KAP questionnaire is designed according to elements required in the infection control strategies related to HA-BSI, and in reference to internationally-recognized standardized and validated KAP instruments. Results:  A total of 1396 cases of HA-BSI occurred during the time between January 2014 and December 2018. A pilot study has been conducted on150 HA-BSI cases and 150 controls. Initial results indicated high response rate (92%) and cooperation rate (94%). Data collection tools have been standardized to the local setup (Cronbach’s a = 0.06). Pilot assessment indicated high inter-rater reliability (Pearson’s r coefficient= 0.88); and high validity parameters (content, construct & criterion). Conclusion:    Study protocol has been designed & validated to explore HA-BSI prevalence estimation, risk factors profile. Initial piloting indicated high applicability of study tools to local context.

Relevant Publications in Journal of Infectious Diseases: Prevention and Control