Abstract:
Background: Hospital-acquired infections are among the most common adverse events in
healthcare, causing substantial morbidity, mortality, and financial burden worldwide. These
infections are often associated with multidrug-resistant organisms, affecting not only individual
patients but also the wider community.
Objective, this study aimed to assess treatment outcomes and associated factors of hospital
acquired infection among adult patients admitted to Hiwot Fana Comprehensive Specialized
University Hospital from 1 February 2024 to 30 April 2024.
Method: A prospective longitudinal study was conducted among adult patients admitted to Hiwot
Fana Comprehensive Specialized Hospital during the study period. A total of 422 patients were
included in the study, selected through systematic random sampling with sampling interval of 2.
Data was collected by using organized questioner. Treatment outcomes were classified into two
categories: good and poor. Descriptive statistics and bivariate and Multivariable logistic
regression analysis was performed, to determine factors associated with poor treatment outcome
with results expressed as adjusted odds ratios (AOR) and 95% confidence intervals (CI). Statistical
significance was determined at a p-value < 0.05.
Result: Of 422 patients observed in this study, 99 (23.5%) were diagnosed with a hospital
acquired infection. Of most commonly identified hospital acquired infections, bloodstream
infections were the most common (37, 37.4%), followed by hospital-acquired pneumonia (35,
35.4%) and urinary tract infections (19, 19.2%). Overall, 50.5% (95% CI: 40.3-60.7) of patients
with hospital-acquired infections experienced poor treatment outcomes. Patients with a Charlson
comorbidity index score ≥ 3 had higher odds of poor outcomes (AOR = 3.45; 95% CI: 1.02–11.57),
bloodstream infection (AOR = 4, 57; 95% CI: 1.06–19.7), prior use of antibiotics before hospital
acquired infection diagnosis (AOR = 3.92; 95% CI: 1.18–13.06), and undergoing an invasive
procedure (AOR = 3.69; 95% CI: 1.15–11.9) were all significantly associated with poor treatment
outcomes.
Conclusion: This study demonstrated that half of the patients with hospital-acquired infections
experienced poor treatment outcomes. Factors significantly associated with adverse outcomes
included a Charlson Comorbidity Index (CCI) score ≥3, bloodstream infections, prior antibiotic
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use before HAI diagnosis, and undergoing invasive procedures. These findings highlight the
combined influence of comorbidities, infection type, and treatment practices on patient prognosis,
underscoring the urgent need for targeted interventions to reduce mortality and improve recovery
among hospitalized adults
