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.
Sohn
Annette H
AH
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia, USA.
Parvez
Farah M
FM
Vu
Tien
T
Hai
Hoang H
HH
Bich
Nguyen N
NN
Le Thu
Thi A
TA
Le Hoa
Thi T
TT
Thanh
Nguyen H
NH
Viet
Truong V
TV
Archibald
Lennox K
LK
Banerjee
Shailen N
SN
Jarvis
William R
WR
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