INCIDENCE OF HOOSPITAL ACQUIRED INFECTION, TREATMENT OUTCOMES AND FACTORS ASSOCIATED WITH POOR TREATMENT OUTCOMES AMONG ADULT INPATIENTS WITH HOSPITAL ACQUIERD INFECTION AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA PROSPECTIVE LONGTUDNAL STUDY

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 xi 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