Impact of Clinical Factors on Nosocomial Infections and Bacterial Resistance in Resuscitation Settings in Abidjan, Côte d’Ivoire: Retrospective Cross-Sectional Study

Kouamé Koffi Isidore,1,2 Mobio N’kan Michael Paterne,1,2 Bouh Kouesseu Judith,1,2 Konan Kouassi Jean,1,2 Coulibaly Klinna Theodore,1,3 Toure Walamitien Cyril,1,2 Sai Servais Sontia,1,4 Bable Koffi Suy,1,2 Kouakou Homawo José,1,2 Yapo Yapo Paul1,2 1Department of Anesthesia, Resuscitation, and Emergency Medicine, Felix Houphouët Boigny University, Abidjan, Ivory Coast; 2Anesthesia and Intensive Care Unit, Yopougon University Hospital Center, Abidjan, Ivory Coast; 3Anesthesia and Intensive Care Unit, Bingerville Mother and Child Hospital, Abidjan, Ivory Coast; 4Anesthesia and Intensive Care Unit, Treichville University Hospital Center, Abidjan, Ivory CoastCorrespondence: Kouamé Koffi Isidore, Email [email protected]: Nosocomial infections (NIs) are a key indicator of healthcare quality. This study aimed to identify the main determinants of NIs in the intensive care unit (ICU) of Yopougon University Hospital, providing updated local data to improve care quality and guide prevention strategies.Methods: This was a retrospective, descriptive, and analytical cross-sectional study conducted over 11 months in the ICU.Results: We recorded 55 NIs, representing 17.52% of ICU admissions. The male-to-female ratio was 1.80, with an average age of 42.00 ± 20.29 years. Hypertension (28.34%) and diabetes (8.92%) were the most common comorbidities. The leading causes for admission were consciousness disorders (18.47%), stroke (16.88%), and polytrauma (15.29%). Common invasive procedures included urinary catheter insertion (61.78%), mechanical ventilation (35.99%), venous catheter insertion (13.38%), and external ventricular drain (EVD) insertion (5.73%). Germs were identified in 17 cases (5.41% of NIs), with Klebsiella (29.41%), Pseudomonas (35.29%), and Escherichia coli (17.65%) being the most common. Other germs included Staphylococcus aureus, Acinetobacter spp. and Enterobacter spp. Antibacterial resistance was found in 64.70% of isolates. Factors independently associated with NIs were recent surgery (excluding immediate postoperative), obesity, EVD insertion, anemia, and prolonged hospitalization. Patients with hemodynamic instability or from the surgery department were less likely to develop NIs.Conclusion: This study highlights risk factors such as comorbidities, invasive procedures, and bacterial resistance, emphasizing the need to strengthen hospital infrastructure, adopt prevention policies, and research antibiotic resistance. It stresses managing comorbidities, adhering to aseptic protocols, and involving the public in prevention efforts.Keywords: impact, clinicals factors, occurrence, nosocomial infections, bacterial resistance, intensive care