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Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: Recent trends based on national surveillance reports
Journal
Antimicrobial Resistance and Infection Control
Journal Volume
7
Journal Issue
1
Pages
129
Date Issued
2018
Author(s)
Chiang C.-H.
Yang T.-S.
Matsuda K.
Kim H.B.
Choi Y.H.
Hori S.
Chang F.-Y.
Abstract
Background: Sustainable systematic interventions are important for infection prevention and control (IPC). Data from surveillance of healthcare-associated infections (HAI) provides feedback for implementation of IPC programs. To address the paucity of such data in Asia, we searched for national HAI surveillance and IPC programs in this region. Methods: Data were analysed from open access national surveillance reports of three Asian countries: Taiwan, South Korea and Japan from 2008 to 2015. National IPC programs were identified. Results: There were differences among the countries in surveillance protocols, hospital coverage rates, and national IPC policies and programs. Nevertheless, there was a 53.0% reduction in overall HAI over the 8-year period. This consisted of a decrease from 9.34 to 5.03 infections per 1000 patient-days in Taiwan, from 7.56 to 2.76 in Korea, and from 4.41 to 2.74 in Japan (Poisson regression, all p < 0.05). Across the three countries, Escherichia coli and Candida albicans were the major pathogens for urinary tract infection. Staphylococcus aureus, Acinetobacter baumannii and Enterococcus faecium were common bloodstream pathogens. For pneumonia, S. aureus, A. baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the predominant pathogens, with considerable country differences. There was a 64.6% decrease in the number of isolates of methicillin-resistant S. aureus, 38.4% decrease in carbapenem-resistant P. aeruginosa and 49.2% decrease in carbapenem-resistant A. baumannii (CRAB) in Taiwan (all p < 0.05), and similarly in Korea with the exception of CRAB (30.5 and 50.4% reduction, respectively, both p < 0.05). Conclusion: We found a significant decrease in HAI across the three countries in association with sequential multifaceted interventions such as hand hygiene, care bundles, and antimicrobial stewardships. Further regional collaboration could be forged to develop joint strategies to prevent HAI. ? 2018 The Author(s).
SDGs
Other Subjects
ciprofloxacin; ertapenem; imipenem; meropenem; Acinetobacter baumannii; antibiotic resistance; Article; Candida albicans; clinical protocol; disease surveillance; Enterococcus faecium; Escherichia coli; hand washing; health care policy; health insurance; health program; healthcare associated infection; human; intensive care unit; Japan; Klebsiella pneumoniae; major clinical study; methicillin resistant Staphylococcus aureus; nonhuman; priority journal; Pseudomonas aeruginosa; South Korea; Staphylococcus aureus; Taiwan; trend study; urinary tract infection; cross infection; health survey; incidence; Japan; meta analysis; microbiology; South Korea; Taiwan; Cross Infection; Drug Resistance, Microbial; Health Policy; Humans; Incidence; Intensive Care Units; Japan; Public Health Surveillance; Republic of Korea; Taiwan
Publisher
BioMed Central Ltd.
Type
journal article