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Prevalence of Nosocomial Infection and Antibiotic Use at a University Medical Center in Malaysia

Published online by Cambridge University Press:  21 June 2016

Andrew J. Hughes*
Affiliation:
Department of Medicine, Geelong Hospital, Victoria, Australia
Norliza Ariffin
Affiliation:
Infectious Diseases Unit, Department of Medicine, Kuala Lumpur, Malaysia
Tan Lien Huat
Affiliation:
Infectious Diseases Unit, Department of Medicine, Kuala Lumpur, Malaysia
Habibah Abdul Molok
Affiliation:
Infection Control Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Salbiah Hashim
Affiliation:
Infection Control Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Juliana Sarijo
Affiliation:
Infection Control Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Nor Harlida Abd Latif
Affiliation:
Infection Control Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Yasmin Abu Hanifah
Affiliation:
Infection Control Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Adeeba Kamarulzaman
Affiliation:
Infectious Diseases Unit, Department of Medicine, Kuala Lumpur, Malaysia
*
91 Camden Road, Newtown, Victoria 3220, Australia

Abstract

Background and Objective:

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 exMnined the rate of N1 in our institution.

Methods:

A point-prevalence study of N1 and antibiotic prescribing was conducted. On July 16 and 17, 2001, all inpatients were surveyed for N1, 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.

Setting:

Tertiary-care referral center in Malaysia.

Patients:

All inpatients during the time of the study.

Results:

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 (12.29-6), 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%. N1 treatment accounted for 36% of antibiotic courses prescribed but 47% of antibiotic cost. Cost of antibiotic acquisition for N1 treatment was estimated to be approximately 2 million per year (Malaysian dollars).

Conclusion:

Whereas the rate of N1 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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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