Nosocomial infections are a common and increasing problem globally, and particularly in Africa. The significant economic burden of these
infections on the health care system as well as their impact on patient morbidity and mortality is well recognised within the medical communities.The goal of this study was to investigate factors that influence
nosocomial infection in all in-patients from the surgery wards (surgery ward A and B, Gynoeco-obstetrics, urology and
intensive care) at the national hospital of Point G in Bamako, Mali. We report the number of
nosocomial infection during a prospective study between June 2003 and January 2004. Of 1043 in-patients, 102 had had a
nosocomial infection with a global prevalence of 9.7% (8.0-11.4). Of 1024 patients with surgery, 101 had had a
nosocomial infection, a post-surgery
nosocomial infection rate of 9.8% (8.1-11.5). We observed different site of
nosocomial infection such as
suppuration sup-aponevrotics (41.2%), parietal
infection sub-aponevrotics (32.4%), urinary
infection (17.6%) and organ
suppuration (3.9%). Other
nosocomial infection observed were
pneumonia (2.9%) and catheterisation (2.0%). The
nosocomial infection rate was 10.3% in male while it was 7.3% in female. The difference between male and female was not statistically significative (chi2 = 2.33, p = 0.12).
Nosocomial infection was more prevalent in patients after emergency surgery (15.1%) than in scheduled surgery patients (8.5%) (chi2 = 8.15, p = 0.004). The classes III and IV of ALTEMEIER had the higher proportion of
nosocomial infection (35.9%) against 4.8% for the classes I and II (chi2 = 144.95, p < 0.001). The patients with ASA score I had a lower
nosocomial infection rate than patients from the intensive care unit or patients of Class II + III + IV (chi2 = 13.2, p = 0.001). Patients classified according to the National
Nosocomial Infection Surveillance System (NNISS) with a score 0 had a
nosocomial infection rate less than patients classified as NNISS score 1, 2 or 3 (chi2 = 82.0, p < 0.001). The study results underline the need for further investigations of the role of microbial agents and antimicrobial resistance in the outcome of patients with
nosocomial infection.