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2022-05-03Zeitschriftenartikel
Baseline study for improving diagnostic stewardship at secondary health care facilities in Nigeria
dc.contributor.authorEgwuenu, Abiodun
dc.contributor.authorEjikeme, Adaora
dc.contributor.authorTomczyk, Sara
dc.contributor.authorvon Laer, Anja
dc.contributor.authorAyobami, Olaniyi
dc.contributor.authorOdebajo, Oluwaseun
dc.contributor.authorAkhibi, Samuel
dc.contributor.authorAgulanna, Constance
dc.contributor.authorOsagie, Osayande
dc.contributor.authorInweregbu, Ugochi Stellamaris
dc.contributor.authorYahaya, Ridwan
dc.contributor.authorOkwor, Tochi
dc.contributor.authorDada‑Adegbola, Hannah
dc.contributor.authorAjayi, Ikeoluwapo
dc.contributor.authorOlorukooba, Abdulhakeem
dc.contributor.authorEckmanns, Tim
dc.contributor.authorOchu, Chinwe Lucia
dc.contributor.authorIhekweazu, Chikwe
dc.date.accessioned2022-06-20T12:44:59Z
dc.date.available2022-06-20T12:44:59Z
dc.date.issued2022-05-03none
dc.identifier.other10.1186/s13756-022-01080-4
dc.identifier.urihttp://edoc.rki.de/176904/9835
dc.description.abstractBackground: Blood culture diagnostics are critical tools for sepsis management and antimicrobial resistance (AMR) surveillance. A baseline study was conducted to assess reported sepsis case finding, blood culture diagnostics, antimicrobial susceptibility testing (AST) and antimicrobial use at secondary health care facilities to inform the development of diagnostic stewardship improvement strategies in Nigeria. Methods: A cross-sectional online survey was conducted among 25 public secondary health care facilities in Abuja, Federal Capital Territory (FCT) and Lagos State in Nigeria to evaluate the capacity for pathogen identification and AST. Data were then prospectively extracted on all patients with reported suspected sepsis from electronic medical records from selected departments at two facilities in the Federal Capital Territory from October 2020 to May 2021 to further assess practices concerning sepsis case-finding, clinical examination findings, samples requested, and laboratory test results. Data were descriptively analysed, and a multivariate logistic regression analysis was conducted to determine factors associated with blood culture requests. Results: In the online survey, 32% (8/25) of facilities reported performing blood cultures. Only one had access to a clinical microbiologist, and 28% (7/25) and 4% (1/25) used standard bacterial organisms for quality control of media and quality control strains for AST, respectively. At the two facilities where data abstraction was performed, the incidence of suspected sepsis cases reported was 7.1% (2924/41066). A majority of these patients came from the paediatrics department and were outpatients, and the median age was two years. Most did not have vital signs and major foci of infection documented. Blood cultures were only requested for 2.7% (80/2924) of patients, of which twelve were positive for bacteria, mainly Staphylococcus aureus. No clinical breakpoints were used for AST. Inpatients (adjusted odds ratio [aOR]: 7.5, 95% CI: 4.6–12.3) and patients from the urban health care facility (aOR:16.9, 95% CI: 8.1–41.4) were significantly more likely to have a blood culture requested. Conclusion: Low blood culture utilisation remains a key challenge in Nigeria. This has implications for patient care, AMR surveillance and antibiotic use. Diagnostic stewardship strategies should focus on improving access to clinical microbiology expertise, practical guidance on sepsis case finding and improving blood culture utilisation and diagnostics.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectSepsiseng
dc.subjectBlood cultureeng
dc.subjectAntibiotic useeng
dc.subjectDiagnostic stewardshipeng
dc.subjectNigeriaeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleBaseline study for improving diagnostic stewardship at secondary health care facilities in Nigerianone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/9835-7
dc.type.versionpublishedVersionnone
local.edoc.container-titleAntimicrobial Resistance & Infection Controlnone
local.edoc.container-issn2047-2994none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01080-4none
local.edoc.container-publisher-nameBioMed Centralnone
local.edoc.container-volume11none
local.edoc.container-issue65none
local.edoc.container-year2022none
dc.description.versionPeer Reviewednone

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