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Prevalence of Surgical-Site Infections and Patterns of Antimicrobial Use in a Large Tertiary-Care Hospital in Ho Chi Minh City, Vietnam

  • Annette H. Sohn (a1) (a2), Farah M. Parvez (a1) (a2), Tien Vu (a1), Hoang H. Hai (a3), Nguyen N. Bich (a3), Le Thi A. Thu (a3), Le Thi T Hoa (a3), Nguyen H. Thanh (a3), Truong V. Viet (a3), Lennox K. Archibald (a1), Shailen N. Banerjee (a1) and William R. Jarvis (a1)...



Few studies have been conducted in Vietnam on the epidemiology of healthcare-associated infections or antimicrobial use. Thus, we sought to determine the prevalence of and risk factors for surgical-site infections (SSIs) and to document antimicrobial use in surgical patients in a large healthcare facility in Vietnam.


We conducted a point-prevalence survey of SSIs and antimicrobial use at Cho Ray Hospital, Ho Chi Minh City, a 1,250-bed inpatient facility. All patients on the 11 surgical wards and 2 intensive care units who had surgery within 30 days before the survey date were included.


Of 391 surgical patients, 56 (14.3%) had an SSI. When we compared patients with and without SSIs, factors associated with infection included trauma (relative risk [RR], 2.65; 95% confidence interval [CI95], 1.60 to 4.37; P < .001), emergency surgery (RR, 2.74; CI95, 1.65 to 4.55; P < .001), and dirty wounds (RR, 3.77; CI95, 2.39 to 5.96; P < .001). Overall, 198 (51%) of the patients received antimicrobials more than 8 hours before surgery and 390 (99.7%) received them after surgery. Commonly used antimicrobials included third-generation cephalosporins and aminoglycosides. Thirty isolates were identified from 26 SSI patient cultures; of the 25 isolates undergoing antimicrobial susceptibility testing, 22 (88%) were resistant to ceftriaxone and 24 (92%) to gentamicin.


Our data show that (1) SSIs are prevalent at Cho Ray Hospital; (2) antimicrobial use among surgical patients is widespread and inconsistent with published guidelines; and (3) pathogens often are resistant to commonly used antimicrobials. SSI prevention interventions, including appropriate use of antimicrobials, are needed in this population.


Corresponding author

Division of Pediatric Infectious Diseases, University of California–San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143-0136


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1.Danchaivijitr, S, Chokloikaew, S. A national prevalence study on nosocomial infections 1988. J Med Assoc Thai 1989;72(suppl 2):16.
2.Kumarasinghe, G, Goh, H, Tan, KN. Hospital acquired infections in a Singapore Hospital: 1985-1992. Malays J Pathol 1995;17:1721.
3.Oni, AA, Bakare, RA, Okesola, AO, Ogunlowo, HA, Ewete, AF. Pattern of bacterial pathogens in surgical wound infections. Afr J Med Med Sci 1997;26:139140.
4.Korinek, A, the French Study Group of Neurosurgical Infections, the Service Epidémiologic, Hygiène et Prévention, and the C-CLIN Paris-Nord. Risk factors for neurosurgical site infections after craniotomy: a prospective multicenter study of 2,944 patients. Neurosurgery 1997;41:10731079.
5.Patir, R, Mahapatra, AK, Banerji, AK. Risk factors in postoperative neurosurgical infection: a prospective study. Acta Neurochir (Wien) 1992; 119:8084.
6.Santos, KR, Fonseca, LS, Bravo Neto, GP, Gontijo Filho, PP. Surgical site infection: rates, etiology, and resistance patterns to antimicrobials among strains isolated at Rio de Janeiro University Hospital. Infection 1997;25:217220.
7.Lim, VKE, Cheong, YM, Suleiman, AB. The use of surgical antibiotic prophylaxis in seven Malaysian hospitals. Southeast Asian J Trop Med Public Health 1994;25:698701.
8.Thamlikitkul, V, Danchaivijitr, S, Kongpattanakul, S, Ckokloikaew, S. Impact of an educational program on antibiotic use in a tertiary care hospital in a developing country. J Clin Epidemiol 1998;51:773778.
9.Okeke, IN, Lamikanra, A, Edelman, R. Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries. Emerg Infect Dis 1999;5:1827.
10.Vo, TCM. Theo doi muc do khang thuoc in vitro o benh vien Cho Ray nam 1997. Benh Vien Cho Ray-Tai Lieu Lam Sang Chon Loc 1999;23:8991.
11.Hoa, NTT; Diep, TS, Wain, J, et al. Community-acquired septicaemia in southern Viet Nam: the importance of multidrug-resistant Salmonella typhi. Trans R Soc Trop Med Hyg 1998;92:503508.
12.Tran, TS, Jamulitrat, S, Chongsuvivatvong, V, Geater, A. Postoperative hospital-acquired infection in Hungvuong Obstetric and Gynaecological Hospital, Vietnam. J Hosp Infect 1998;40:141147.
13.Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR, the Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:247278.
14.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.
15.Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606608.
16.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests, 6th ed. Approved standard. Wayne, PA: National Committee for Clinical Laboratory Standards; 1997. NCCLS document M2-A6.
17.Dean, AG, Dean, JA, Coulombier, D, et al. Epi Info Version 6: A Word Processing, Database, and Statistics Program for Epidemiology on Microcomputers. Atlanta, GA: Centers for Disease Control and Prevention; 1995.
18.SAS Institute, Inc. SAS, Release 6.12, Software for Data Analysis. Cary, NC: SAS Institute, Inc.; 1996.
19.Horan, TC, Culver, DH. Comparing surgical site infection rates. In: Association for Professionals in Infection Control and Epidemiology, Inc. (APIC). APIC Text of Infection Control and Epidemiology, 1st ed. Washington, DC: APIC; 2000:14.114.7.
20.Culver, DH, Horan, TC, Gaynes, RP, et al. Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 1991;91:152S157S.
21.Weinstein, JW, Mazon, D, Pantelick, E, Reagan-Cirincione, P, Dembry, LM, Hierholzer, WJ Jr. A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infect Control Hosp Epidemiol 1999;20:543548.
22.The EPINE Working Group. Prevalence of hospital-acquired infection in Spain. J Hosp Infect 1992;20:113.
23.Vincent, JL, Bihari, DJ, Suter, PM, et al. The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) study. JAMA 1995;274:639644.
24.Vietnam News Agency. Helmets may become mandatory on highways. Viet Nam News July 21, 2000:1.
25.Vietnam News Agency. Stricter measures to be introduced to reduce road accidents: Deputy Prime Minister. Viet Nam News July 27, 2000:2.
26.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1997, issued May 1997. Am J Infect Control 1997;25:477487.
27.Gedebou, J, Tassew, A, Azene, G. Frequency and resistance patterns of bacterial isolates from surgical patients in a teaching hospital in Addis Ababa. Tropical and Geographical Medicine 1983;35:133138.
28.Centers for Disease Control. Public health focus: Surveillance, prevention, and control of nosocomial infections. MMWR 1992;41:783787.
29.Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725730.

Prevalence of Surgical-Site Infections and Patterns of Antimicrobial Use in a Large Tertiary-Care Hospital in Ho Chi Minh City, Vietnam

  • Annette H. Sohn (a1) (a2), Farah M. Parvez (a1) (a2), Tien Vu (a1), Hoang H. Hai (a3), Nguyen N. Bich (a3), Le Thi A. Thu (a3), Le Thi T Hoa (a3), Nguyen H. Thanh (a3), Truong V. Viet (a3), Lennox K. Archibald (a1), Shailen N. Banerjee (a1) and William R. Jarvis (a1)...


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