National Survey of Thai Infectious Disease Physicians on Treatment of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia: The Role of Infection Control Awareness.
OBJECTIVE To evaluate the expected and treatment outcomes of Thai infectious disease physicians (IDPs) regarding carbapenem-resistant Acinetobacter baumannii (CRAB) ventilator-associated pneumonia (VAP) METHODS From June 1, 2014, to March 1, 2015, survey data regarding the expected and clinical success rates of CRAB VAP treatment were collected from all Thai IDPs. The expected success rate was defined as the expectation of clinical response after CRAB VAP treatment for the given case scenario. Clinical success rate was defined as the overall reported success rate of CRAB VAP treatment based on the clinical practice of each IDP. The expected and clinical success rates were divided into low (80%) categories and were then compared with standard clinical response rates archived in the existing literature. RESULTS Of 183 total Thai IDPs, 111 (60%) were enrolled in this study. The median expected and clinical success rates were 68% and 58%, respectively. Using multivariate analysis, we determined that working in a hospital that implemented the standard intervention combined with an intensified infection control (IC) intervention for CRAB (adjusted odds ratio [aOR], 3.01; 95% confidence interval [CI], 1.17-7.73; P=.02) was associated with standard and high expected rates (>60%). Being a board-certified IDP (aOR, 5.76; 95% CI, 2.16-15.37; P60%). We identified a significant correlation between expected and clinical success rates (r=0.58; P<.001). CONCLUSIONS Awareness of IC among IDPs can improve physicians' expected and clinical success rates for CRAB VAP treatment, and treatment experience impacts overall treatment success. Infect. Control Hosp. Epidemiol. 2015;37(1):61-69.
1Division of Infectious Diseases, Faculty of Medicine,Thammasat University,Pathumthani,Thailand.
Aubonphan
A
Buppajarntham
1Division of Infectious Diseases, Faculty of Medicine,Thammasat University,Pathumthani,Thailand.
Anucha
A
Apisarnthanarak
1Division of Infectious Diseases, Faculty of Medicine,Thammasat University,Pathumthani,Thailand.
Thana
T
Khawcharoenporn
1Division of Infectious Diseases, Faculty of Medicine,Thammasat University,Pathumthani,Thailand.
Sasinuch
S
Rutjanawech
2Division of Infectious Diseases,Children's National Medical Center,Department of Pediatrics,Epidemiology and Global Health,George Washington University,School of Medicine and Health Sciences,School of Public Health,Washington DC,United States.
Nalini
N
Singh
D040981:Acinetobacter baumannii / Q000187:drug effects; D000328:Adult; D015780:Carbapenems / Q000494:pharmacology; D002568:Certification / Q000706:statistics & numerical data*; D002983:Clinical Competence; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D017053:Infection Control; D055552:Infectious Disease Medicine / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013785:Thailand; D016896:Treatment Outcome
D015780:Carbapenems