ABSTRACT
Background: Pediatric patients are at increased risk of nosocomial infections with multi-drug resistant pathogens which are more prevalent in the hospital environment. The aim of this study was to determine the prevalence of nosocomial infections, antibiotic resistance pattern of bacterial isolates and associated factors in pediatric patients. Methods: This was a cross-sectional study conducted from March to August, 2016. Data included sociodemographic and clinical variables in patients clinically suspected of having nosocomial infections and collected using a structured questionnaire. Bacterial identification and antimicrobial susceptibility test was done with standard microbiological methods. Data were analyzed with SPSS version 20 and p value < 0.05 was considered to be statistically significant. Results: Out of 939 children admitted to the hospital, 384 patients (40.9%) were clinically suspected and had 462 nosocomial infections. Blood stream infection was the most common site of nosocomial infections. Culture confirmed nosocomial infections were reported in 82 patients (21.4%; 95% CI, 17.2-25.8%) with 88 isolates. Among the most frequently isolated bacteria, 21 (23.9%) were Klebsiella spp, and 16 (18.2%) were S. aureus, 62.5% of which were methicillin resistant. Among all bacterial pathogens, 88.9% were multi-drug resistant. Extremely high (97.9%) multi-drug resistance was associated with Gram negative bacteria. Among these, all isolates, except E. coli, were 100% multi-drug resistant. Long hospital stay and malnutrition were significantly associated with nosocomial infections. Conclusion: The high prevalence of nosocomial infections with multi-drug resistant bacteria suggests the need for proper implementation of the nosocomial infections prevention and control measures