Shrestha R, Koju P, Xinliang Liu, Maharjan B, Madhup S, Shah P, Hao Li
Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre. Pharmacovigilance Unit/ Research and Development Division, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre.
Pharmacovigilance Unit/ Research and Development Division, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre.
Kathmandu Univ Med J (KUMJ). 2019;17(68):329-335.
Background Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are among the most serious public health problems and overall estimate indicates that at any point, over 1.4 million people are suffering from health care associated infection globally. According to the WHO report, the frequency of nosocomial infection is 10% in South East Asia where as 7% in developed countries. The increasing trend of AMR in pathogenic bacteria leads to complication to treat HAIs and failure in treatment and rise in mortality. Objective The study was conducted with the objective of to explore the incidence of different types of HAIs and AMR pattern in the patients admitted in a tertiary care hospital. Method The cross-sectional study was conducted at the tertiary care hospital and the patient who are one year or older and admitted for more than 48 hours were included in this study. The criteria for classification of HAIs were adapted from Centers for Disease Control. All the samples were collected then antibiotic sensitivity testing was conducted according to CLSI standards. Data were collected using a structured data collection form. Data were entered in EpiData software and analyzed using SPSS version 22. Result Among 2326 patients, female was slightly higher than male patients, where 77 (3.3%) patients experienced at least one episode of HAIs. The surgical site infection (71.42%) is the most common infection followed by Catheter Associated Urinary Tract Infection (18.18%) and Health Care Associated Pneumonia (6.49%). Mean hospitalization days is higher with HAI (14.5 days) compared to non-HAI (6.6 days). Out of 909 specimens, urine, sputum and blood were higher in numbers, where 217 bacterial isolates were isolated with Escherichia coli (83 isolates) was the most common bacteria. It is found that Escherichia coli bacterial isolates were resistance to most common antibiotics. Conclusion The study concludes that surgical site infection is the most common healthcareassociated infection and Escherichia coli is the most common bacteria responsible for HAIs. Further, surgical site infection being the most common infection, there is an urgent need to take effective infection prevention and control prevention.
背景 抗菌药物耐药性（AMR）和医疗保健相关感染（HAIs）是最严重的公共卫生问题之一，总体估计表明，全球任何时候都有超过140万人患有医疗保健相关感染。根据世界卫生组织的报告，东南亚医院感染的发生率为10%，而发达国家为7%。病原菌中AMR的增加趋势导致治疗HAIs的复杂性、治疗失败和死亡率上升。目的 本研究旨在探讨三级医院住院患者中不同类型HAIs的发生率和AMR模式。方法 在三级医院进行横断面研究，纳入年龄在1岁及以上、住院时间超过48小时的患者。HAIs的分类标准采用美国疾病控制中心的标准。收集所有样本，然后根据CLSI标准进行抗生素敏感性测试。使用结构化数据收集表收集数据。数据录入EpiData软件，并使用SPSS 22版进行分析。结果 在2326例患者中，女性略多于男性，其中77例（3.3%）患者至少经历过一次HAIs。手术部位感染（71.42%）是最常见的感染，其次是导管相关尿路感染（18.18%）和医疗保健相关肺炎（6.49%）。与非HAIs患者（6.6天）相比，HAIs患者的平均住院天数更高（14.5天）。在909份标本中，尿液、痰液和血液的数量较多，共分离出217株细菌，其中大肠埃希菌（83株）是最常见的细菌。发现大肠埃希菌分离株对最常用的抗生素耐药。结论 本研究得出结论，手术部位感染是最常见的医疗保健相关感染，大肠埃希菌是导致HAIs的最常见细菌。此外，由于手术部位感染是最常见的感染，迫切需要采取有效的感染预防和控制措施。
