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Integrated one-day surveillance of antimicrobial use, antimicrobial consumption, antimicrobial resistance, healthcare-associated infection, and antimicrobial resistance burden among hospitalized patients in Thailand.

Authors
  • Thamlikitkul, Visanu1
  • Rattanaumpawan, Pinyo2
  • Sirijatuphat, Rujipas2
  • Wangchinda, Walaiporn2
  • 1 Division of Infectious Diseases and Tropical Medicine, Department of Medicine, and the World Health Organization Collaborating Centre for Antimicrobial Resistance Prevention and Containment, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand. Electronic address: [email protected] , (Thailand)
  • 2 Division of Infectious Diseases and Tropical Medicine, Department of Medicine, and the World Health Organization Collaborating Centre for Antimicrobial Resistance Prevention and Containment, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand. , (Thailand)
Type
Published Article
Journal
The Journal of infection
Publication Date
Apr 30, 2020
Identifiers
DOI: 10.1016/j.jinf.2020.04.040
PMID: 32360884
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Surveillance of antimicrobial use (AMU), antimicrobial consumption (AMC), antimicrobial resistance (AMR), healthcare-associated infection (HAI), and AMR burden are usually measured by time-consuming and expensive multiple separate longitudinal surveys. This study aimed to investigate feasibility and benefit of integrated one-day surveillance to estimate and monitor these parameters. Integrated one-day surveillance of AMU, AMC, AMR, HAI, and AMR burden among hospitalized patients in 183 hospitals in Thailand was conducted. Parameter data was collected for each patient who received antibiotic on a survey day. AMU prevalence was 51.5% among 23,686 hospitalized patients. The most commonly used antibiotic for infection prophylaxis and treatment was cefazolin and ceftriaxone, respectively. The most common infection was pneumonia. Community-associated infection (CAI) was observed in 64.9%, and 34.1% had HAI. Prevalence of AMR was highest in A. baumannii infection. AMR in bacteria was more prevalent among HAI than among CAI. Consumption of all antibiotics was 18,103 defined daily doses. HAI prevalence was 14.0%. Health and economic burden were much higher in patients with antibiotic-resistant infection. Integrated one-day surveillance of these important parameters among hospitalized patients is feasible and can be used for estimation and monitoring from the facility-level to the national-level in resource-limited settings. Copyright © 2020. Published by Elsevier Ltd.

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