Hospital-associated infections in Rwanda

In a pilot project at the University Teaching Hospital of Butare, we aim at reducing these infections by improved provision of alcohol-based hand rub. In parallel, the rate of infection and colonisation with antibiotic-resistant microorganisms (MRSA/ESBL) among hospital patients and their family members, respectively, is assessed. At the University Teaching Hospital of Butare, patients and attending care-takers (family members) are screened for the carriage of multidrug-resistant bacteria (ESBL). A high proportion of carriage is observed already at admission to hospital, and a substantial number of admitted patients additionally acquire carriage of ESBL bacteria during hospital stay. Patients and their home environment are screened two months after discharge from hospital to quantify the spread of multidrug-resistant bacteria from hospital to community. Further investigations aim at identifying transmission pathways in the community (e.g., livestock, water sources, environment, food).