Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units.
BACKGROUND:Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. METHODS:Monthly repeated point preva...
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doaj-0b3fe7e5dc1241b39ead4fc5a16e8b2f2020-11-25T00:03:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01111e014754410.1371/journal.pone.0147544Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units.Vu Dinh PhuHeiman F L WertheimMattias LarssonBehzad NadjmQuynh-Dao DinhLennart E NilssonUlf RydellTuyet Thi Diem LeSon Hong TrinhHung Minh PhamCang Thanh TranHanh Thi Hong DoanNguyen Thua TranNhan Duc LeNhuan Van HuynhThao Phuong TranBao Duc TranSon Truong NguyenThao Thi Ngoc PhamTam Quang DangChau Van Vinh NguyenYen Minh LamGuy ThwaitesKinh Van NguyenHakan HanbergerBACKGROUND:Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. METHODS:Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. RESULTS:Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). CONCLUSION:A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts.http://europepmc.org/articles/PMC4732823?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vu Dinh Phu Heiman F L Wertheim Mattias Larsson Behzad Nadjm Quynh-Dao Dinh Lennart E Nilsson Ulf Rydell Tuyet Thi Diem Le Son Hong Trinh Hung Minh Pham Cang Thanh Tran Hanh Thi Hong Doan Nguyen Thua Tran Nhan Duc Le Nhuan Van Huynh Thao Phuong Tran Bao Duc Tran Son Truong Nguyen Thao Thi Ngoc Pham Tam Quang Dang Chau Van Vinh Nguyen Yen Minh Lam Guy Thwaites Kinh Van Nguyen Hakan Hanberger |
spellingShingle |
Vu Dinh Phu Heiman F L Wertheim Mattias Larsson Behzad Nadjm Quynh-Dao Dinh Lennart E Nilsson Ulf Rydell Tuyet Thi Diem Le Son Hong Trinh Hung Minh Pham Cang Thanh Tran Hanh Thi Hong Doan Nguyen Thua Tran Nhan Duc Le Nhuan Van Huynh Thao Phuong Tran Bao Duc Tran Son Truong Nguyen Thao Thi Ngoc Pham Tam Quang Dang Chau Van Vinh Nguyen Yen Minh Lam Guy Thwaites Kinh Van Nguyen Hakan Hanberger Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. PLoS ONE |
author_facet |
Vu Dinh Phu Heiman F L Wertheim Mattias Larsson Behzad Nadjm Quynh-Dao Dinh Lennart E Nilsson Ulf Rydell Tuyet Thi Diem Le Son Hong Trinh Hung Minh Pham Cang Thanh Tran Hanh Thi Hong Doan Nguyen Thua Tran Nhan Duc Le Nhuan Van Huynh Thao Phuong Tran Bao Duc Tran Son Truong Nguyen Thao Thi Ngoc Pham Tam Quang Dang Chau Van Vinh Nguyen Yen Minh Lam Guy Thwaites Kinh Van Nguyen Hakan Hanberger |
author_sort |
Vu Dinh Phu |
title |
Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. |
title_short |
Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. |
title_full |
Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. |
title_fullStr |
Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. |
title_full_unstemmed |
Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. |
title_sort |
burden of hospital acquired infections and antimicrobial use in vietnamese adult intensive care units. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2016-01-01 |
description |
BACKGROUND:Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. METHODS:Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. RESULTS:Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). CONCLUSION:A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. |
url |
http://europepmc.org/articles/PMC4732823?pdf=render |
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