Prevalence of Nosocomial Infection and Antibiotic Use at a University Medical Center in Malaysia •
Most reports of nosocomial infection (NI) prevalence have come from developed countries with established infection control programs. In developing countries, infection control is often not as well established due to lack of staff and resources. We examined the rate of NI in our institution.
A point-prevalence study of NI and antibiotic prescribing was conducted. On July 16 and 17, 2001, all inpatients were surveyed for NI, risk factors, pathogens isolated, and antibiotics prescribed and their indication. NIs were diagnosed according to CDC criteria. Cost of antibiotic acquisition was calculated by treatment indication.
Tertiary-care referral center in Malaysia.
All inpatients during the time of the study.
Five hundred thirty-eight patients were surveyed. Seventy-five had 103 NIs for a prevalence of 13.9%. The most common NIs were urinary tract infections (12.2%), pneumonia (21.4%), laboratory-confirmed bloodstream infections (12.2%), deep surgical wound infections (11.2%), and clinical sepsis (22.4%). Pseudomonas aeruginosa, MRSA, and MSSA were the most common pathogens. Two hundred thirty-seven patients were taking 347 courses of antibiotics, for an overall prevalence of antibiotic use of 44%. NI treatment accounted for 36% of antibiotic courses prescribed but 47% of antibiotic cost. Cost of antibiotic acquisition for NI treatment was estimated to be approximately 2 million per year (Malaysian dollars).
Whereas the rate of NI is relatively high at our center compared with rates from previous reports, antibiotic use is among the highest reported in any study of this kind. Further research into this high rate of antibiotic use is urgently required.
Available from: Norio Ohmagari
- "orf1, gene encoding a hypothetical protein; orf2, gene encoding a DNA-binding protein; orf3, gene encoding a DNA replication protein; orf4 and orf5, genes encoding hypothetical proteins 30.8 % of the prescribed antibiotics were considered in- appropriate. This latter rate was higher than the rates of inappropriately prescribed antibiotics in Malaysia (4.0 %), Turkey (14.0 %), Hong Kong (20.0 %)and European countries (17.8–32.0 %)[53,54]. "
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ABSTRACT: Background: Acinetobacter baumannii strains co-producing carbapenemase and 16S rRNA methylase are highly resistant to carbapenems and aminoglycosides. Methods: Ninety-three isolates of multidrug-resistant A. baumannii were obtained from an intensive care unit in a hospital in Vietnam. Antimicrobial susceptibility tests and whole genome sequencing were performed. Multilocus sequence typing and the presence of drug resistant genes were determined and a maximum-likelihood phylogenetic tree was constructed by SNP alignment of whole genome sequencing data. Results: The majority of isolates belonged to clonal complex 2 (ST2, ST570 and ST571), and carried carbapenemase encoding genes bla OXA-23 and bla OXA-66. Two isolates encoded carbapenemase genes bla NDM-1 and bla OXA-58 and the 16S rRNA methylase encoding gene armA and did not belong to clonal complex 2 (ST16). Conclusion: A. baumannii isolates producing 16S rRNA methylase ArmA and belonging to clonal complex 2 are widespread, and isolates co-producing NDM-1 and ArmA are emerging, in medical settings in Vietnam.
Available from: ccsenet.org
- "Nosocomial infections are defined as infections occur within 48 hours after hospital admission, 3 days after discharge or 30 days after an operation (WHO, 2002). Prevalence of NIs are varies between 1.5 to 26.1 percent among different countries (Hashemi et al., 2010; Leaper et al., 2004; Kim et al., 2000; Gastmeier et al., 2001; Haley et al., 1985; Behnke et al., 2013; Petersen et al., 2010; Hughes et al., 2005; Nguyen et al., 2001; Balkhy et al., 2006; Saleem et al., 2013). Prevalence of NIs in Iranian hospitals reported between %1.3 to %10 (Hashemi et al., 2010; Askarian et al., 2012; Hajibagheri et al., 2006; Qorbanalizadehgan et al., 2008; Barak et al., 2012; Hojat et al., 2012; Hosseinrezaei et al., 2012). "
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Antibiotic resistance as one of the most serious health threats worldwide leading to a high rate of morbidity and mortality. The aim of present study was to examine the prevalence of nosocomial infections (NIs) and pattern of antibiotic resistance in teaching hospitals in Iran.
This cross-sectional descriptive study was conducted in a period of one year in three teaching hospitals and all patients with suspected NIs symptoms were chooses. Among these patients who showed antibiotic resistance were included in the study. The samples for clinical test in laboratory were obtained with using standard methods and aseptic technique by trained personnel. Antibiotic susceptibility testing was performed by Kirby-Bauer's disk diffusion method on Muller-Hinton agar (Hi Media, Mumbai, India) in accordance with the standards of the Clinical Laboratory Standards Institute.
During one year study, 561 patients with nosocomial infections were recognized and among them 340 patients (60.6%) showed some level of antibiotic resistance. The most common cause of NIs in present study was Acinetobacter and the most type of infection was respiratory system infections (52.7%). The highest resistance rate was against Ciprofloxacin (61.8%) followed by Imipenem (50.3%).
Rate of NIs and antibiotics resistance is high in Iranian hospital. So Iranian health ministry should provide guideline and suitable programs for prevention of NIs and antibiotic therapy in hospitals.
Available from: Jun Leong Wong
- "Every year, several billions spent in healthcare sector was solely for the management of HCAI cases. In 2001, one of the tertiary-care referral hospital in Malaysia spent 1.98 million Ringgit Malaysia only on antibiotics for treating HCAI (Hughes et al., 2005). Hands play a major role in the transmission of infection in healthcare institutions. "
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ABSTRACT: Hands of Health Care Personnel (HCP) are one of the most common vehicles for the transmission of infection. Microorganisms can survive well on the hands of HCP for a certain duration. Therefore, the purpose of this study is to bring awareness to HCP that their hands can actually be contaminated with many microorganisms. These microbes on the hands of HCP can potentially infect their patients if they do not comply with the proper hand hygiene practice. This cross-sectional study was conducted at a randomly selected Intensive Care Unit (ICU) and general ward in a hospital. Twenty five HCP from each ward were randomly selected and their hands were imprinted on blood culture plates. Microorganism growth were quantified and identified. Data were analyzed and presented as descriptive analysis. One hundred blood agar plates were processed and analyzed. Majority (71%) of the samples had more than 50 colony-forming units (CFU) and only 17% of the samples had less than 25 CFU. Microorganisms identified include Staphylococcus spp., Acinetobacter spp., Enterobacteriaceae, Pseudomonas spp., Moraxella, Delftiaacidovorans and fungi. All isolated microorganisms were antibiotic sensitive strain. This study showed that the hands of HCP were contaminated with many microorganisms. Therefore, it is imperative that HCP must practice proper hand hygiene when taking care of their patients in the wards.
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