Aerobic bacterial nosocomial infections in paediatric surgical patients at a tertiary health institution in Lagos, Nigeria.

This study was undertaken to determine nosocomial bacterial infections (NI) in surgical patients in a developing country using the detailed option of the Center for Disease Control (CDC) surgical patient surveillance technique. From 1994 - 1995. Paediatrics surgical patients at the Lagos University Teaching Hospital (LUTH) were prospectively monitored for NI at all body sites. Standard definitions of NI were used, and NI sites were categorised by type of operation. A total of 304 NI occurred in 245 out of 664 surgical patients investigated. SSI (77.3 %) and urinary tract infections (19.1%) were in preponderance. Seventy three per cent of SSI were superficial incisions, 20.5% organ/space and 6.8% deep incisions. The overall wound infection rate was 30.9%. The SSI rate for emergency surgery was 35.6% and 26.5% for elective procedures. Rates within each wound class were 20.2, 23.8, 51.9 and 52.8% respectively and 17, 37.6, 43.4 and 47. 1% for patients with ASA scores of I II III and IV in that order. The SSI rates for patients with scores of 0, 1, 2 and 3 were 20.4; 43.5, 57.1 and 75% respectively. Mean infection rates in the various wound classes were highly correlated with the number of risk factors present. Klebsiella pneumoniae (38. 7%), Escherichia coli (22.7%), Pseudomonas aeruginosa (16.8%) and Staphylococcus aureus (10. 7%) were the most common pathogens.