Curtis Stephanie J, Barnabas Roland, Cairns Kelly A, Cameron Donna, Coghlan Benjamin, Jones Robert, Joseph Jacklyn, Kali Alu, Kep Dimitri, Klintworth Gemma, Levy Stephanie, Mason Matt, Norrie Majella, Peel Trisha, Tamolsaian Gilam, Telenge Josephine, Tumu Nellie, Stewardson Andrew J, Ak Gabriella
Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University, 85 Commercial Road, Melbourne, Australia.
Port Moresby General Hospital - 3 Mile, Taurama Road National Capital District, Port Moresby, Papua New Guinea.
Lancet Reg Health West Pac. 2024 Jun 18;48:101120. doi: 10.1016/j.lanwpc.2024.101120. eCollection 2024 Jul.
Healthcare-associated infections (HAI) and antimicrobial use (AMU) are drivers for antimicrobial resistance, and robust data are required to inform interventions and track changes. We aimed to estimate the prevalence of HAI and AMU at Port Moresby General Hospital (PMGH), the largest hospital in Papua New Guinea.
We did a point prevalence survey (PPS) on HAI and AMU at PMGH in May 2023 using the European Centre for Disease Prevention and Control (ECDC) PPS protocol. We included all critical care patients and randomly sampled half of the patients in other acute-care wards. We calculated weighted HAI and AMU prevalence estimates to account for this sampling strategy. Weighted HAI estimates were also calculated for an expanded definition that included physician diagnosis.
Of 361 patients surveyed in 18 wards, the ECDC protocol identified 28 HAIs in 26 patients, resulting in a weighted HAI prevalence of 6.7% (95% CI: 4.6, 9.8). Surgical site infections (9/28, 32%) were the most common HAI. When adding physician diagnosis to the ECDC definitions, more skin and soft tissue, respiratory, and bloodstream HAIs were detected, and the weighted HAI prevalence was 12.4% (95% CI: 9.4, 16.3). The prevalence of AMU was 66.5% (95%CI: 61.3, 71.2), and 73.2% (263/359) of antibiotics were from the World Health Organization Access group.
This is the first reported hospital PPS of HAI and AMU in Papua New Guinea. These results can be used to prioritise interventions, and as a baseline against which future point prevalence surveys can be compared.
Australian Government Department of Foreign Affairs and Trade and Therapeutic Guidelines Limited Australia.
医疗保健相关感染（HAI）和抗菌药物使用（AMU）是抗菌药物耐药性的驱动因素，需要可靠的数据来为干预措施提供信息并跟踪变化。我们旨在估计巴布亚新几内亚最大的医院——莫尔斯比港总医院（PMGH）的HAI和AMU患病率。
我们于2023年5月在PMGH按照欧洲疾病预防控制中心（ECDC）的点患病率调查（PPS）方案，对HAI和AMU进行了一项点患病率调查。我们纳入了所有重症监护患者，并在其他急性护理病房中随机抽取了一半患者。我们计算了加权HAI和AMU患病率估计值，以考虑这种抽样策略。还针对包括医生诊断在内的扩展定义计算了加权HAI估计值。
在18个病房调查的361名患者中，ECDC方案确定26名患者发生了28例HAI，加权HAI患病率为6.7%（95%置信区间：4.6，9.8）。手术部位感染（9/28，32%）是最常见的HAI。当将医生诊断纳入ECDC定义时，检测到更多的皮肤和软组织、呼吸道及血流HAI，加权HAI患病率为12.4%（95%置信区间：9.4，16.3）。AMU患病率为66.5%（95%置信区间：61.3，71.2），73.2%（263/359）的抗生素来自世界卫生组织基本药物清单。
这是巴布亚新几内亚首次报告的关于HAI和AMU的医院PPS。这些结果可用于确定干预措施的优先级，并作为未来点患病率调查的比较基线。
澳大利亚外交部和贸易部以及澳大利亚治疗指南有限公司。
