Nosocomial infections in traumatology-orthopedics: Epidemiological, clinical, bacteriological aspects and associated factors in Cotonou

Introduction: Experienced in a dramatic way, nosocomial infections weigh down the care of patients. This work aimed to study the epidemiological aspects, clinical and bacteriological characteristics of these infections, then to look for factors associated with each nosocomial infection in traumatology-orthopedics. Methods: This was a descriptive and analytical retrospective study, including patients hospitalized in the traumatology-orthopedics department of CNHU-HKM of Cotonou, and having contracted a nosocomial infection over the period from October 2012 to September 2016. The minimum follow-up was two years. The sociodemographic, clinical and bacteriological variables were studied. The statistical analysis was carried out with the Fischer test with calculation of the p value. A value less than or equal to 0.05 was statistically significant. Results: The hospital frequency of nosocomial infections was 8.3% (N=100). The predominance was male with 76% of men. The average age was 40.1±13.4 years. Civil servants (45%) were the most affected. Fever (97 cases) and purulent discharge (91 cases) were the most frequent signs. The diagnosis of the infection was made on average in 26.5±24.5 days. In decreasing order of frequency, these were surgical site infection (95 cases), urinary tract infection (11 cases), venitis (08 cases) and pulmonary infection (04 cases). The main causative agent was Staphylococcus aureus followed by Klebsiella pneumoniae. The factors associated with the type of nosocomial infections found were: diagnostic delay for surgical site infections (p = 0.02) and profession for urinary tract infections (p = 0.02). Conclusion: Nosocomial infections in traumatology-orthopedics are dominated by surgical site infections in our context. The establishment of reliable protocols to combat these infections remains a challenge.