Open Access Highly Accessed Research article

Incidence, pathogens and resistance patterns of nosocomial infections at a rural hospital in Gabon

Micha Scherbaum12, Katrin Kösters13, Raymund Egid Mürbeth14, Ulysse Ateba Ngoa12, Peter Gottfried Kremsner12, Bertrand Lell12* and Abraham Alabi12

Author Affiliations

1 Centre de Recherches Medicales de Lambarene, Albert Schweitzer Hospital, PB 118 Lambaréné, Gabon

2 Department for Tropical Medicine, Eberhard-Karls-University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany

3 Department of Internal Medicine II, Helios Clinic Krefeld, Lutherplatz 40, 47805 Krefeld, Germany

4 Third Medical Clinic, Augsburg Hospital, Stenglingstr 2, 86156 Augsburg, Germany

For all author emails, please log on.

BMC Infectious Diseases 2014, 14:124  doi:10.1186/1471-2334-14-124

Published: 4 March 2014



Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambaréné, Gabon.


This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections.


A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms.


The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

Nosocomial infections; Antibiotic resistance; Gabon