Background: Catheter-associated urinary tract infections (CAUTIs) are among the most prevalent healthcare-associated infections (HAIs) globally, contributing to increased morbidity, prolonged hospital stays, and increased healthcare costs. Interventions that support prompt removal of the urinary catheter are evidence-based actions to effectively reduce CAUTI rates.1Objective: At the National Hospital of Tropical Disease (NHTD), catheter removal interventions in the intensive care unit (ICU) were implemented using quality improvement (QI) methodology to reduce CAUTI incidence and urinary catheter device utilization. Methods: Training was performed for ICU clinical staff with knowledge checks before and after the program. A bedside visual reminder of CAUTI risk and checklist to assess catheter need were implemented. Weekly compliance of provided visual reminders and checklists were measured using a simple audit tool. Device utilization ratios (DURs, ratios of device days to patient days), and CAUTI incidence rates (per 1,000 device days) were collected at baseline (July–September 2018) and quarterly thereafter until June 2019. Statistical significance was determined by an independent t test. Results: In the first quarter (October–December 2018), the CAUTI incidence rate decreased from 8.9 to 1.3 per 1,000 device days (P = .036). The ICU staff trained in CAUTI prevention, mean knowledge scores before and after training increased from 68% to 87%. The DUR decreased slightly from 0.59 to 0.55 after the first-quarter training then steadily increased in the following quarter (0.60; January–March 2019) and after the intervention (0.54; April–June 2019). CAUTI incidence rates also increased but were still lower than at baseline: 4.8 and 6.3 per 1,000 days of device use. Compliance of reminders was 51% during the first quarter, increased slightly in the second quarter 62%, then decreased to 40% during the last quarter. The nurses’ adherence to the daily checklist remained stable (>75%). Conclusions: This CAUTI prevention project was the first use of quality improvement methodology to implement change at NHTD. A trend decrease in CAUTI was observed, though a greater decrease occurred at the beginning of the intervention. Limited compliance of daily reminders is likely reflected in no statistically significant decrease in DUR. Possibly, this quality improvement project raised awareness among clinicians to improve general CAUTI prevention practices in the ICU without decreasing DUR. Given limited compliance with reminder and checklists, the intervention will be revised during the next PDSA cycle to improve adherence.

1Meddings J, Rogers MA, Krein SL, Fakih MG, Olmsted RN, Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2014;23:277–289.

Funding: None

Disclosures: None

Non-typhoidal Salmonella (NTS) serovars, sequences types and antimicrobial susceptibility profiles have specific associations with animal and human infections in Vietnam. Antimicrobial resistance may have an effect on the manifestation of human NTS infections, with isolates from asymptomatic individuals being more susceptible to antimicrobials than those associated with animals and human diarrhoea.

Strongyloidiasis is a neglected tropical disease caused by the roundworm Strongyloides stercoralis affecting 30–100 million people worldwide. Many Southeast-Asian countries report a high prevalence of S. stercoralis infection, but there are little data from Vietnam. Here, we evaluated the seroprevalence of S. stercoralis related to geography, sex and age in Vietnam through serological testing of anonymized sera. Sera (n = 1710, 1340 adults and 270 children) from an anonymized age-stratified serum bank from four regions in Vietnam between 2012 and 2013 were tested using a commercial Strongyloides ratti immunoglobulin G ELISA. Seroreactivity was found in 29·1% (390/1340) of adults and 5·5% (15/270) of children. Male adults were more frequently seroreactive than females (33·3% vs. 24·9%, P = 0·001). The rural central highlands had the highest seroprevalence (42·4% of adults). Seroreactivity in the other regions was 29·9% (Hue) and 26·0% and 18·2% in the large urban centres of Hanoi and Ho Chi Minh City, respectively. We conclude that seroprevalence of S. stercoralis was high in the Vietnamese adult population, especially in rural areas.

We evaluate the effects of climate change on Vietnam's rice market. Results suggest that under a low-emission scenario and without interventions, rice production would drop by as much as 18% by 2030 relative to the 1980–1999 average. Farm and wholesale prices would increase by 1.86%, causing domestic demand to fall by 0.38%. The export sector would experience a rise of 6.94% in export free-on-board prices and a drop of 55.36% in export quantities. Farmers would experience a sales loss of 16.02%, whereas wholesalers would see a sales gain of 1.48%. For exporters, their sales loss would amount to 48.42%.

Let (X, 0) be a germ of an analytic space and f the germ of an analytic function on X. We show that the polar filtration of the local Milnor fiber, defined by a projection on a complex disc, is diffeomorphic to a valuative filtration of the Milnor fiber called Hironaka's filtration, a result which links invariants associated with the singularities of the projection to those associated with a desingularisation.

Let

(formula here)

be the germ of a finite (that is, proper with finite fibres) complex analytic morphism from a complex analytic normal surface onto an open neighbourhood U of the origin 0 in the complex plane C2. Let u and v be coordinates of C2 defined on U. We shall call the triple (π, u, v) the initial data.

Let Δ stand for the discriminant locus of the germ π, that is, the image by π of the critical locus Γ of π.

Let (Δα)α∈A be the branches of the discriminant locus Δ at O which are not the coordinate axes.

For each α ∈ A, we define a rational number dα by

(formula here)

where I(–, –) denotes the intersection number at 0 of complex analytic curves in C2. The set of rational numbers dα, for α ∈ A, is a finite subset D of the set of rational numbers Q. We shall call D the set of discriminantal ratios of the initial data (π, u, v). The interesting situation is when one of the two coordinates (u, v) is tangent to some branch of Δ, otherwise D = {1}. The definition of D depends not only on the choice of the two coordinates, but also on their ordering.

In this paper we prove that the set D is a topological invariant of the initial data (π, u, v) (in a sense that we shall define below) and we give several ways to compute it. These results are first steps in the understanding of the geometry of the discriminant locus. We shall also see the relation with the geometry of the critical locus.