HEALTHCARE-ASSOCIATED INFECTIONS AT SELECTED HOSPITALS IN THAILAND.
Weerawat ManosuthiVaraporn ThientongVisal MoolasartYong RongrungruengChariya SangsajjaSomwang DanchaivijitrPublished in: The Southeast Asian journal of tropical medicine and public health (2018)
This study aimed to determine the prevalence of healthcare-associated
infections (HAIs), all-cause mortality, document the bacterial pathogens isolated in
HAIs, and determine the risk factors associated with HAIs and all-cause mortality
at selected hospitals in Thailand. A survey with a total time frame of 10 days was
conducted at selected 50 hospitals across Thailand during January 2014: 19 primary
government hospitals, 15 secondary government hospitals, 13 tertiary government
hospitals, 2 private hospitals and 1 government university hospital. Of 15,475 cases
reviewed, 688 patients had 791 HAIs (1.1 HAI per infected patient). The rate of
HAI was 4.4% (95%CI: 4.1-4.8): 7.3% (95%CI: 4.6-9.3) at the university hospital
surveyed, 5.0% (95%CI: 4.6-5.4) at the tertiary hospitals surveyed, 3.9% (95%CI:
3.4-4.6) at the secondary hospitals surveyed, 2.0% (95%CI: 1.3-2.7) at the primary
hospitals surveyed, and 1.6% (95%CI: 0.5-2.8) at the private hospitals surveyed.
The ward with the frequent number of HAI was the intensive care unit (17%). The
two most commonly affected age ranges were those aged >60 years and <1 year.
Of the 791 HAIs found in this survey, the 3 most frequently reported types of HAI
were: respiratory tract infections (n=377, 48%), urinary tract infections (n=176,
22%) and surgical site infections (n=55, 7%). Of the 688 patients with a HAI, 24%
died within three months of this survey. The most frequently reported bacterial
pathogen was Acinetobacter species (17%). On multivariate analysis, HAIs were
significantly associated with patient age <1 year, a university hospital, having
major surgery, urinary catheterization, being on a respiratory ventilator, having
a tracheostomy, and having central venous catheterization (p <0.05). Death was
associated with patient age <1 year, a university hospital, being on a surgical
or medical ward, being on a ventilator, and having a central venous catheter (p
<0.05). HAIs are major public health problems in the studied hospitals and result
in substantial mortality.
Keyphrases
- healthcare
- public health
- respiratory tract
- mental health
- case report
- ejection fraction
- end stage renal disease
- minimally invasive
- newly diagnosed
- acute respiratory distress syndrome
- chronic kidney disease
- coronary artery disease
- health insurance
- candida albicans
- social media
- acinetobacter baumannii
- peritoneal dialysis
- ultrasound guided
- prognostic factors
- patient reported outcomes
- extracorporeal membrane oxygenation
- affordable care act