FREQUENCY, PREVALENCE AND RISK FACTORS OF NOSOCOMIAL INFECTIONS: THE CASE OF A MULTIDISCIPLINARY HOSPITAL IN TBILISI, GEORGIA

Abstract

Background: Nosocomial infections, also known as healthcare-associated infections, remain a major challenge for healthcare systems worldwide, contributing to increased morbidity, mortality, length of hospital stay, and healthcare costs. Despite established surveillance regulations in Georgia, hospital-level data on infection patterns and risk factors remain limited.

Objective: To determine the prevalence, major clinical forms, risk factors, and causative microorganisms of nosocomial infections in a multidisciplinary hospital in Tbilisi.

Materials and Methods: A retrospective descriptive study was conducted using medical records and electronic data of hospitalized patients treated between 01 January 2023 and 01 January 2024. Among 2,984 hospitalized patients, 2,494 remained in hospital for more than 48 hours and were considered at risk. Nosocomial infections were identified and analyzed by type of hospitalization, age, outcomes, invasive procedures, and microbiological findings. Descriptive statistical methods were applied.

Results: A total of 59 nosocomial infections were identified, yielding an incidence of 2.37%, which was below internationally recommended thresholds. The case fatality rate was 27.1%. The most frequent infections were pneumonia (33.9%) and urinary tract infections (33.9%), followed by bloodstream infections (22.0%) and surgical site infections (10.2%). Most infections occurred among emergency-admitted patients (88.1%) and patients aged ≥71 years (54.2%). Prolonged hospitalization and invasive procedures—including mechanical ventilation, urinary catheterization, and central venous catheterization—were identified as universal risk factors. Gram-negative multidrug-resistant bacteria, particularly Klebsiella pneumoniae and Acinetobacter baumannii, predominated. A reduction in infection incidence was observed following hand hygiene training for medical staff.

Conclusions: Although the incidence of nosocomial infections remained within acceptable limits, the high mortality rate highlights the vulnerability of elderly, critically ill, and emergency-admitted patients. Strengthening infection prevention and control measures, improving surveillance and outcome attribution, and targeting high-risk groups are essential to reduce the burden of nosocomial infections.