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High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs A multi-centre point prevalence survey
Natl Hosp Pediat, Hanoi, Vietnam.
Univ Oxford, Clin Res Unit, Hanoi, Vietnam; Univ Oxford, Ctr Trop Med, Nuffield Dept Med, Oxford, England; Radboudumc, RCI, Dept Med Microbiol, Nijmegen, Netherlands.
Natl Hosp Trop Dis, Hanoi, Vietnam.
Natl Hosp Pediat, Hanoi, Vietnam.
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2016 (Engelska)Ingår i: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 95, nr 27, artikel-id e4099Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

There is scarce information regarding hospital-acquired infections (HAIs) among children in resource-constrained settings. This study aims to measure prevalence of HAIs in Vietnamese pediatric hospitals. Monthly point prevalence surveys (PPSs) in 6 pediatric intensive care units (ICUs) in 3 referral hospitals during 1 year. A total of 1363 cases (1143 children) were surveyed, 59.9% male, average age 11 months. Admission sources were: other hospital 49.3%, current hospital 36.5%, and community 15.3%. Reasons for admission were: infectious disease (66%), noninfectious (20.8%), and surgery/trauma (11.3%). Intubation rate was 47.8%, central venous catheter 29.4%, peripheral venous catheter 86.2%, urinary catheter 14.6%, and hemodialysis/filtration 1.7%. HAI was diagnosed in 33.1% of the cases: pneumonia (52.2%), septicemia (26.4%), surgical site infection (2%), and necrotizing enterocolitis (2%). Significant risk factors for HAI included age under 7 months, intubation and infection at admission. Microbiological findings were reported in 212 cases (43%) with 276 isolates: 50 Klebsiella pneumoniae, 46 Pseudomonas aeruginosa, and 39 Acinetobacter baumannii, with carbapenem resistance detected in 55%, 71%, and 65%, respectively. Staphylococcus aureus was cultured in 18 cases, with 81% methicillin-resistant Staphylococcus aureus. Most children (87.6%) received antibiotics, with an average of 1.6 antibiotics per case. Colistin was administered to 96 patients, 93% with HAI and 49% with culture confirmed carbapenem resistance. The high prevalence of HAI with carbapenem resistant gram-negative strains and common treatment with broad-spectrum antibiotics and colistin suggests that interventions are needed to prevent HAI and to optimize antibiotic use.

Ort, förlag, år, upplaga, sidor
LIPPINCOTT WILLIAMS & WILKINS , 2016. Vol. 95, nr 27, artikel-id e4099
Nyckelord [en]
hospital-acquired infections; ICU; pediatric; Vietnam
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Allmänmedicin
Identifikatorer
URN: urn:nbn:se:liu:diva-131585DOI: 10.1097/MD.0000000000004099ISI: 000380372400052PubMedID: 27399106OAI: oai:DiVA.org:liu-131585DiVA, id: diva2:974742
Anmärkning

Funding Agencies|Swedish International Development Agency (Sida); Wellcome Trust (UK); Global Antibiotic Resistance Partnership (GARP)

Tillgänglig från: 2016-09-27 Skapad: 2016-09-27 Senast uppdaterad: 2018-01-10

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Nilsson, Lennart ERydell, UlfHanberger, Håkan
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Avdelningen för mikrobiologi och molekylär medicinMedicinska fakultetenInfektionskliniken i Östergötland
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