Prevalence of surgical-site infections and patterns of antimicrobial use in a large tertiary-care hospital in Ho Chi Minh City, Vietnam.
BACKGROUND
Few studies have been conducted in Vietnam on the epidemiology of healthcare-associated infections or antimicrobial use. Thus, we sought to determine the prevalence of and risk factors for surgical-site infections (SSIs) and to document antimicrobial use in surgical patients in a large healthcare facility in Vietnam.


METHODS
We conducted a point-prevalence survey of SSIs and antimicrobial use at Cho Ray Hospital, Ho Chi Minh City, a 1,250-bed inpatient facility. All patients on the 11 surgical wards and 2 intensive care units who had surgery within 30 days before the survey date were included.


RESULTS
Of 391 surgical patients, 56 (14.3%) had an SSI. When we compared patients with and without SSIs, factors associated with infection included trauma (relative risk [RR], 2.65; 95% confidence interval [CI95], 1.60 to 4.37; P < .001), emergency surgery (RR, 2.74; CI95, 1.65 to 4.55; P < .001), and dirty wounds (RR, 3.77; CI95, 2.39 to 5.96; P < .001). Overall, 198 (51%) of the patients received antimicrobials more than 8 hours before surgery and 390 (99.7%) received them after surgery. Commonly used antimicrobials included third-generation cephalosporins and aminoglycosides. Thirty isolates were identified from 26 SSI patient cultures; of the 25 isolates undergoing antimicrobial susceptibility testing, 22 (88%) were resistant to ceftriaxone and 24 (92%) to gentamicin.


CONCLUSIONS
Our data show that (1) SSIs are prevalent at Cho Ray Hospital; (2) antimicrobial use among surgical patients is widespread and inconsistent with published guidelines; and (3) pathogens often are resistant to commonly used antimicrobials. SSI prevention interventions, including appropriate use of antimicrobials, are needed in this population.
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia, USA.
Annette H
AH
Sohn
Farah M
FM
Parvez
Tien
T
Vu
Hoang H
HH
Hai
Nguyen N
NN
Bich
Thi A
TA
Le Thu
Thi T
TT
Le Hoa
Nguyen H
NH
Thanh
Truong V
TV
Viet
Lennox K
LK
Archibald
Shailen N
SN
Banerjee
William R
WR
Jarvis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology
D000890:Anti-Infective Agents