Published in PLOS One on 2025-12-26, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Abera Abiye Jaguba, Bekan Alemu, Temesgen Leka Lerango, Hailu Chare Koyra
Source: PLOS One • DOI 10.1371/journal.pone.0339116
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Hospital-acquired infections (HAIs) are a global health concern. Inappropriate treatment of HAIs worsens their impact, contributing to increased antimicrobial resistance, higher healthcare costs, and heightened morbidity and mortality. However, evidence on inappropriate treatment of HAIs in resource-constrained settings remains limited. The aim of this study was to assess the prevalence and associated factors of inappropriate treatment of HAIs among admitted adults in Wolaita Zone hospitals, Southern Ethiopia.
A multicenter cross-sectional study was conducted in selected hospitals in the Wolaita Zone from 28 October 2024–25 February 2025, enrolling 280 patients with HAIs. Data were collected via structured face-to-face interviews and medical record review. Data were entered in EpiData 4.6 and analyzed in SPSS 25. A binary logistic regression model was employed to examine the associations between the outcome variable and explanatory variables, with statistical significance determined at a p-value < 0.05.
The mean (± SD) age of participants was 41.25 ± 12.5 years. Pneumonia was the most frequently diagnosed HAI (133, 47.5%). Streptococcus species, Staphylococcus aureus, and Klebsiella pneumoniae were the predominant pathogens isolated. The overall prevalence of inappropriate treatment of HAI was 53.6% (95% CI: 47.5–59.5). The odds of inappropriate treatment of HAI were significantly higher in the presence of comorbidity (AOR = 2.69, 95% CI: 1.45–5.01; p = 0.002) and among patients treated in the surgical ward (AOR = 2.75, 95% CI: 1.32–5.74; p = 0.007). Conversely, culture testing (AOR = 0.34, 95% CI: 0.15–0.74; p = 0.007) and provision of clinical pharmacy service (AOR = 0.28, 95% CI: 0.13–0.60; p = 0.001) were associated with reduced odds of inappropriate treatment of HAIs.
The prevalence of inappropriate treatment of HAIs among admitted adults in the current study settings was high. Comorbidities, treatment ward type, culture testing, and the provision of clinical pharmacy services were significantly associated with inappropriate treatment. Clinicians should give particular attention to patients with comorbidities and those receiving care in surgical wards. Health facilities should enhance microbiological diagnostic services to promote evidence-based therapy. Additionally, clinical pharmacy services should be expanded across hospital wards to support efforts in reducing inappropriate treatment of HAIs. These findings underscore the urgent need for multifaceted interventions to improve patient care and combat antimicrobial resistance in this setting.
Introduction
Hospital acquired infections (HAIs) are illnesses, either localized or systemic, that develop as a reaction to an infectious agent, bacteria, or its toxins that were present in hospital settings but were not incubating or exhibiting symptoms when the patient was admitted to the hospital [1,2]. These infections are usually of nosocomial origin and typically manifest clinically at least 48 hours after hospital admission or within 30 days after having received health care [3,4]. The most common HAIs include surgical site infection (SSI), catheter-associated urinary tract infection (CAUTI), hospital-acquired pneumonia (HAP), bloodstream infection (BSI), skin and soft tissue infections (SSTIs), and healthcare-associated Clostridium difficile infection (HCACDI) [5–10]. Hospital-acquired infections represent one of the most common adverse events in healthcare delivery [11].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2025 Abera Abiye Jaguba, Bekan Alemu, Temesgen Leka Lerango, Hailu Chare Koyra. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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