Prevalence and risk factors of health care–associated infections in a limited resources country: A cross-sectional study.

• Health care–associated infection prevalence remains high in Southern Tunisia. • Intrinsic risk factors included immune-suppression, diabetes, and malnutrition. • Extrinsic risk factors represented the targets of hospital infection control. The aim of this study was to determine the prevalence of health care–associated infections (HAI) in our university hospitals (UH) and to delineate the risk factors associated with HAI. We conducted a cross-sectional study in the 2 UH of Sfax, Tunisia on July 2017, including all patients hospitalized for at least 48 hours. It was a 1-day pass per department and a 1-week prevalence survey per UH. Of 752 patients eligible for the study, the total number of HAI was 82, representing an overall prevalence of HAI of 10.9%. Respiratory tract infections were the most prevalent HAI (36.6%). In multivariate analysis, intrinsic risk factors independently associated with HAI were immune-suppression (adjusted odds ratio (AOR) = 2.8; P <.001), diabetes (AOR = 2.2; P =.008), and malnutrition (AOR = 2.2; P =.019). Extrinsic risk factors were endotracheal intubation (AOR = 17; P =.01), transfer to another department (AOR = 9; P =.019), parental feeding (AOR = 7.2; P =.014), tobacco use (AOR = 6.3; P =.004), as well as surgical wound class contaminated or dirty (AOR = 6.3; P =.002), and peripheral venous catheter (AOR = 4.7; P =.006). Our study highlighted the magnitude of the HAI problem threatening the quality of care in Southern Tunisia. A wise identification of HAI risk factors may help health care workers to ascertain the avoidability of these infections. [ABSTRACT FROM AUTHOR]