Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units
Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Monthly repeated point prevalence surveys were...
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| Published in: | PloS one Vol. 11; no. 1; p. e0147544 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Public Library of Science
29-01-2016
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| Abstract | Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam.
Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included.
Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively).
A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. |
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| AbstractList | Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. BACKGROUNDVietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam.METHODSMonthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included.RESULTSAmong 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively).CONCLUSIONA high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. |
| Audience | Academic |
| Author | Rydell, Ulf Dang, Tam Quang Tran, Bao Duc Phu, Vu Dinh Pham, Hung Minh Wertheim, Heiman F L Van Nguyen, Kinh Thwaites, Guy Nguyen, Son Truong Huynh, Nhuan Van Trinh, Son Hong Nguyen, Chau Van Vinh Pham, Thao Thi Ngoc Doan, Hanh Thi Hong Tran, Cang Thanh Hanberger, Hakan Le, Tuyet Thi Diem Larsson, Mattias Le, Nhan Duc Tran, Thao Phuong Nadjm, Behzad Nilsson, Lennart E Dinh, Quynh-Dao Tran, Nguyen Thua Lam, Yen Minh |
| AuthorAffiliation | 13 Board of Directors, Da Nang Hospital, Da Nang, Vietnam 17 Board of Directors, Cho Ray Hospital, Ho Chi Minh City, Vietnam 5 Clinical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden 16 Planning Department, Dak Lak Hospital, Dak Lak, Vietnam 20 Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam 2 Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam 3 Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom 1 Intensive Care Unit, National Hospital for Tropical Diseases, Ha Noi, Vietnam 6 Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden 10 Intensive Care Unit, Viet Tiep Hospital, Hai Phong, Vietnam 18 Board of Directors, Can Tho Central General Hosptial, Can Tho, Vietnam 21 Board of Directors, National Hospital for Tropical Disea |
| AuthorAffiliation_xml | – name: 10 Intensive Care Unit, Viet Tiep Hospital, Hai Phong, Vietnam – name: 11 Board of Directors, Vietnam-Sweden Uong Bi Hospital, Quang Ninh, Vietnam – name: 12 Department of General Internal Medicine & Geriatric, Hue Central General Hospital, Hue, Vietnam – name: 7 Intensive Care Unit, Bach Mai Hospital, Ha Noi, Vietnam – name: 17 Board of Directors, Cho Ray Hospital, Ho Chi Minh City, Vietnam – name: 1 Intensive Care Unit, National Hospital for Tropical Diseases, Ha Noi, Vietnam – name: 15 Intensive Care Unit, Khanh Hoa Hospital, Khanh Hoa, Vietnam – name: 9 Pharmacy, Saint-Paul Hospital, Ha Noi, Vietnam – name: 5 Clinical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden – name: 4 Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden – name: 13 Board of Directors, Da Nang Hospital, Da Nang, Vietnam – name: 21 Board of Directors, National Hospital for Tropical Diseases, Ha Noi, Vietnam – name: 20 Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam – name: 3 Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom – name: 8 Board of Directors, Viet Duc Hospital, Ha Noi, Vietnam – name: 6 Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden – name: 19 Board of directors, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam – name: University Hospital San Giovanni Battista di Torino, ITALY – name: 14 Infectious Department, Binh Dinh Hospital, Binh Dinh, Vietnam – name: 16 Planning Department, Dak Lak Hospital, Dak Lak, Vietnam – name: 2 Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam – name: 18 Board of Directors, Can Tho Central General Hosptial, Can Tho, Vietnam |
| Author_xml | – sequence: 1 givenname: Vu Dinh surname: Phu fullname: Phu, Vu Dinh organization: Intensive Care Unit, National Hospital for Tropical Diseases, Ha Noi, Vietnam – sequence: 2 givenname: Heiman F L surname: Wertheim fullname: Wertheim, Heiman F L organization: Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom – sequence: 3 givenname: Mattias surname: Larsson fullname: Larsson, Mattias organization: Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden – sequence: 4 givenname: Behzad surname: Nadjm fullname: Nadjm, Behzad organization: Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom – sequence: 5 givenname: Quynh-Dao surname: Dinh fullname: Dinh, Quynh-Dao organization: Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam – sequence: 6 givenname: Lennart E surname: Nilsson fullname: Nilsson, Lennart E organization: Clinical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden – sequence: 7 givenname: Ulf surname: Rydell fullname: Rydell, Ulf organization: Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden – sequence: 8 givenname: Tuyet Thi Diem surname: Le fullname: Le, Tuyet Thi Diem organization: Intensive Care Unit, Bach Mai Hospital, Ha Noi, Vietnam – sequence: 9 givenname: Son Hong surname: Trinh fullname: Trinh, Son Hong organization: Board of Directors, Viet Duc Hospital, Ha Noi, Vietnam – sequence: 10 givenname: Hung Minh surname: Pham fullname: Pham, Hung Minh organization: Pharmacy, Saint-Paul Hospital, Ha Noi, Vietnam – sequence: 11 givenname: Cang Thanh surname: Tran fullname: Tran, Cang Thanh organization: Intensive Care Unit, Viet Tiep Hospital, Hai Phong, Vietnam – sequence: 12 givenname: Hanh Thi Hong surname: Doan fullname: Doan, Hanh Thi Hong organization: Board of Directors, Vietnam-Sweden Uong Bi Hospital, Quang Ninh, Vietnam – sequence: 13 givenname: Nguyen Thua surname: Tran fullname: Tran, Nguyen Thua organization: Department of General Internal Medicine & Geriatric, Hue Central General Hospital, Hue, Vietnam – sequence: 14 givenname: Nhan Duc surname: Le fullname: Le, Nhan Duc organization: Board of Directors, Da Nang Hospital, Da Nang, Vietnam – sequence: 15 givenname: Nhuan Van surname: Huynh fullname: Huynh, Nhuan Van organization: Infectious Department, Binh Dinh Hospital, Binh Dinh, Vietnam – sequence: 16 givenname: Thao Phuong surname: Tran fullname: Tran, Thao Phuong organization: Intensive Care Unit, Khanh Hoa Hospital, Khanh Hoa, Vietnam – sequence: 17 givenname: Bao Duc surname: Tran fullname: Tran, Bao Duc organization: Planning Department, Dak Lak Hospital, Dak Lak, Vietnam – sequence: 18 givenname: Son Truong surname: Nguyen fullname: Nguyen, Son Truong organization: Board of Directors, Cho Ray Hospital, Ho Chi Minh City, Vietnam – sequence: 19 givenname: Thao Thi Ngoc surname: Pham fullname: Pham, Thao Thi Ngoc organization: Board of Directors, Cho Ray Hospital, Ho Chi Minh City, Vietnam – sequence: 20 givenname: Tam Quang surname: Dang fullname: Dang, Tam Quang organization: Board of Directors, Can Tho Central General Hosptial, Can Tho, Vietnam – sequence: 21 givenname: Chau Van Vinh surname: Nguyen fullname: Nguyen, Chau Van Vinh organization: Board of directors, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam – sequence: 22 givenname: Yen Minh surname: Lam fullname: Lam, Yen Minh organization: Board of directors, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam – sequence: 23 givenname: Guy surname: Thwaites fullname: Thwaites, Guy organization: Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam – sequence: 24 givenname: Kinh surname: Van Nguyen fullname: Van Nguyen, Kinh organization: Board of Directors, National Hospital for Tropical Diseases, Ha Noi, Vietnam – sequence: 25 givenname: Hakan surname: Hanberger fullname: Hanberger, Hakan organization: Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26824228$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-125684$$DView record from Swedish Publication Index http://kipublications.ki.se/Default.aspx?queryparsed=id:132921832$$DView record from Swedish Publication Index |
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| Copyright | COPYRIGHT 2016 Public Library of Science 2016 Phu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2016 Phu et al 2016 Phu et al |
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| DOI | 10.1371/journal.pone.0147544 |
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| DocumentTitleAlternate | Hospital Acquired Infection in Vietnamese Intensive Care Units |
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| Editor | Costa, Cristina |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: VDP HFLW ML LEN UR HH KVN. Performed the experiments: VDP HFLW ML BN QDD LEN UR TTDL SHT HMP CTT HTHD NTT NDL NVH TPT BDT STN TTNP TQD CVVN YML GT KVN HH. Analyzed the data: VDP HFLW BN QDD HH. Wrote the paper: VDP HFLW BN ML LEN UR HH KVN GT. Current address: Department of medical microbiology, Radboudumc, Nijmegen, Netherlands. Competing Interests: The authors have declared that no competing interests exist. |
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| References | TA Thu (ref12) 2011; 32 (ref5) 2013 H Erdem (ref7) 2014; 68 ref1 VG Vu (ref13); 2008 M Johansson (ref25) 2011; 16 EA Oostdijk (ref28) 2012; 67 (ref11) 2014 (ref20) 2012 JL Vincent (ref30) 2009; 302 HF Wertheim (ref19) 2013; 10 A Dogru (ref31) 2010; 63 DM Livermore (ref32) 2009; 63 Hopkins KS Susan (ref6) 2012 AT Truong (ref16); 2008 VD Rosenthal (ref10) 2012; 40 AT Truong (ref15); 2008 ref22 ref21 L Bouadma (ref27) 2012; 25 TD Van (ref18) 2014; 2 VD Rosenthal (ref8) 2014; 42 B Allegranzi (ref3) 2011; 377 VG Vu (ref14); 2008 L Barrera (ref23) 2011; 39 SS Magill (ref29) 2014; 312 SS Magill (ref4) 2014; 370 KV Nguyen (ref9) 2013; 13 S Hugonnet (ref24) 2007; 165 M Behnke (ref26) 2012; 33 R Laxminarayan (ref2) 2013; 13 HS Nguyen (ref17); 2008 |
| References_xml | – volume: 68 start-page: 131 issue: 2 year: 2014 ident: ref7 article-title: Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran—a prospective multicenter point prevalence study publication-title: J Infect doi: 10.1016/j.jinf.2013.11.001 contributor: fullname: H Erdem – volume: 13 start-page: 1158 year: 2013 ident: ref9 article-title: Antibiotic use and resistance in emerging economies: a situation analysis for Viet Nam publication-title: BMC Public Health doi: 10.1186/1471-2458-13-1158 contributor: fullname: KV Nguyen – volume: 63 start-page: 95 issue: 2 year: 2010 ident: ref31 article-title: The rate of device-associated nosocomial infections in a medical surgical intensive care unit of a training and research hospital in Turkey: one-year outcomes publication-title: Jpn J Infect Dis doi: 10.7883/yoken.63.95 contributor: fullname: A Dogru – ident: ref1 – volume: 377 start-page: 228 issue: 9761 year: 2011 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revived publication-title: J Antimicrob Chemother doi: 10.1093/jac/dkn511 contributor: fullname: DM Livermore – volume: 2008 start-page: 63 issue: 6 ident: ref17 article-title: Incidence rate of nosocomial infections at the intensive care unit of No. 175 military hospital, 2006 publication-title: Journal of Clinical Medicine contributor: fullname: HS Nguyen – year: 2013 ident: ref5 – volume: 13 start-page: 1057 issue: 12 year: 2013 ident: ref2 article-title: Antibiotic resistance-the need for global solutions publication-title: Lancet Infect Dis doi: 10.1016/S1473-3099(13)70318-9 contributor: fullname: R Laxminarayan – year: 2012 ident: ref6 article-title: Preliminary data contributor: fullname: Hopkins KS Susan – volume: 10 start-page: e1001429 issue: 5 year: 2013 ident: ref19 article-title: Providing impetus, tools, and guidance to strengthen national capacity for antimicrobial stewardship in Viet Nam publication-title: PLoS Med doi: 10.1371/journal.pmed.1001429 contributor: fullname: HF Wertheim – volume: 16 start-page: 737 issue: 6 year: 2011 ident: ref25 article-title: Need for improved antimicrobial and infection control stewardship in Vietnamese intensive care units publication-title: Trop Med Int Health doi: 10.1111/j.1365-3156.2011.02753.x contributor: fullname: M Johansson – volume: 2 start-page: 318 issue: 4 year: 2014 ident: ref18 article-title: Antibiotic susceptibility and molecular epidemiology of Acinetobacter calcoaceticus–baumannii complex strains isolated from a referral hospital in northern Vietnam publication-title: Journal of Global Antimicrobial Resistance doi: 10.1016/j.jgar.2014.05.003 contributor: fullname: TD Van – ident: ref21 – volume: 2008 start-page: 51 issue: 6 ident: ref15 article-title: Prevalence of nosocomial infections and its relative factors in Bach Mai hospital 2006 publication-title: Journal of Clinical Medicine contributor: fullname: AT Truong – volume: 40 start-page: 396 issue: 5 year: 2012 ident: ref10 article-title: International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004–2009 publication-title: Am J Infect Control doi: 10.1016/j.ajic.2011.05.020 contributor: fullname: VD Rosenthal – volume: 39 start-page: 633 issue: 8 year: 2011 ident: ref23 article-title: Effectiveness of a hand hygiene promotion strategy using alcohol-based handrub in 6 intensive care units in Colombia publication-title: Am J Infect Control doi: 10.1016/j.ajic.2010.11.004 contributor: fullname: L Barrera – volume: 312 start-page: 1438 issue: 14 year: 2014 ident: ref29 article-title: Prevalence of antimicrobial use in US acute care hospitals, May-September 2011 publication-title: JAMA doi: 10.1001/jama.2014.12923 contributor: fullname: SS Magill – volume: 165 start-page: 1321 issue: 11 year: 2007 ident: ref24 article-title: Nurse staffing level and nosocomial infections: empirical evaluation of the case-crossover and case-time-control designs publication-title: Am J Epidemiol doi: 10.1093/aje/kwm041 contributor: fullname: S Hugonnet – volume: 2008 start-page: 57 issue: 6 ident: ref16 article-title: Incidence of nosocomial infections in the intensive care units in Bach Mai hospital (2002–2003) publication-title: Journal of Clinical Medicine contributor: fullname: AT Truong – volume: 32 start-page: 1039 issue: 10 year: 2011 ident: ref12 article-title: A point-prevalence study on healthcare-associated infections in Vietnam: public health implications publication-title: Infect Control Hosp Epidemiol doi: 10.1086/661915 contributor: fullname: TA Thu – volume: 302 start-page: 2323 issue: 21 year: 2009 ident: ref30 article-title: International study of the prevalence and outcomes of infection in intensive care units publication-title: JAMA doi: 10.1001/jama.2009.1754 contributor: fullname: JL Vincent – volume: 42 start-page: 942 issue: 9 year: 2014 ident: ref8 article-title: International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007–2012. Device-associated module publication-title: Am J Infect Control doi: 10.1016/j.ajic.2014.05.029 contributor: fullname: VD Rosenthal |
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| Title | Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units |
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