Practices to prevent multidrug-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in Thailand: A national survey

详细信息    查看全文

• 作者：Anucha Apisarnthanarak ; MD^a ; ^{anapisarn@yahoo.com} ; Thana Khawcharoenporn ; MD ; MSc^a ; Linda M. Mundy ; MD ; PhD^b
• 关键词：Prevention ; Hospitals ; Nosocomial infection ; Resource-limited setting
• 刊名：American Journal of Infection Control
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：41
• 期：5
• 页码：416-421
• 全文大小：283 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background

Multidrug-resistant organisms (MDRO) are increasing challenges for health care institutions worldwide, and there are many factors associated with their distribution.

Objectives

We conducted a national survey of Thai hospitals with 1 or more intensive care units and ¡Ý250 hospital beds to evaluate hospital characteristics and current practices to minimize the endemic burden of multidrug-resistant (MDR) Acinetobacter baumannii (AB) and methicillin-resistant Staphylococcus aureus (MRSA).

Methods

Research nurses collected survey data from participating hospitals between January 1 and April 30, 2011. Data collection focused on hospital characteristics and practices to prevent endemic MDR-AB and MRSA; logistic regression analyses were used to assess associations between hospital characteristics and infection prevention control (IPC) interventions.

Results

There was an 80 % survey response (N?= 204) from 256 eligible hospitals. Endemic MDR-AB and MRSA were reported in 184 (90 % ) and 100 (40 % ) hospitals, respectively. The most frequently reported IPC interventions were contact isolation, hand hygiene campaigns, and antimicrobial stewardship; active surveillance, chlorhexidine gluconate bathing, and multifaceted interventions were uncommon. By multivariate analysis, having a physician as the lead infection control professional and participation in a collaborative effort to prevent MDR organisms were associated with multifaceted interventions to reduce MDR-AB, and medical school affiliation and participating in a collaborative effort to prevent MDR organisms were associated with multifaceted interventions to reduce MRSA.

Conclusion

Multifaceted interventions to reduce, if not prevent, MDR-AB and MRSA were infrequently reported from Thai hospitals. Our survey findings provide baseline data for IPC interventions for MDR-AB and MRSA. Future efforts that correlate IPC interventions and MDRO trends will help develop evidence-based practices in these resource-limited settings.