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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

Published online by Cambridge University Press:  02 January 2015

Annette H. Sohn*
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Farah M. Parvez
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Tien Vu
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia
Hoang H. Hai
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Nguyen N. Bich
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Le Thi A. Thu
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Le Thi T Hoa
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Nguyen H. Thanh
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Truong V. Viet
Affiliation:
Thanh are from Cho Ray Hospital, Ho Chi Minh City, Vietnam
Lennox K. Archibald
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia
Shailen N. Banerjee
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia
William R. Jarvis
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia
*
Division of Pediatric Infectious Diseases, University of California–San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143-0136

Abstract

Background:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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