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. 2013 Apr;107(4):248-53.
doi: 10.1093/trstmh/trt005. Epub 2013 Feb 14.

The value of intermittent point-prevalence surveys of healthcare-associated infections for evaluating infection control interventions at Angkor Hospital for Children, Siem Reap, Cambodia

N Stoesser  1 , K Emary, S Soklin, K Peng An, S Sophal, S Chhomrath, N P J Day, D Limmathurotsakul, P Nget, Y Pangnarith, S Sona, V Kumar, C E Moore, N Chanpheaktra, C M Parry
Affiliations

The value of intermittent point-prevalence surveys of healthcare-associated infections for evaluating infection control interventions at Angkor Hospital for Children, Siem Reap, Cambodia

N Stoesser et al. Trans R Soc Trop Med Hyg. 2013 Apr.

Abstract

Background: There are limited data on the epidemiology of paediatric healthcare-associated infection (HCAI) and infection control in low-income countries. We describe the value of intermittent point-prevalence surveys for monitoring HCAI and evaluating infection control interventions in a Cambodian paediatric hospital.

Methods: Hospital-wide, point-prevalence surveys were performed monthly in 2011. Infection control interventions introduced during this period included a hand hygiene programme and a ventilator-associated pneumonia (VAP) care bundle.

Results: Overall HCAI prevalence was 13.8/100 patients at-risk, with a significant decline over time. The highest HCAI rates (50%) were observed in critical care; the majority of HCAIs were respiratory (61%). Klebsiella pneumoniae was most commonly isolated and antimicrobial resistance was widespread. Hand hygiene compliance doubled to 51.6%, and total VAP cases/1000 patient-ventilator days fell from 30 to 10.

Conclusion: Rates of HCAI were substantial in our institution, and antimicrobial resistance a major concern. Point-prevalence surveys are effective for HCAI surveillance, and in monitoring trends in response to infection control interventions.

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Figures

Figure 1.
Figure 1.
Percentage of patients on antibiotics by month (calculated as a proportion of all patients surveyed) and on commonly prescribed antibiotics (calculated as a proportion of all patients on antibiotics), January–December 2011.
Figure 2.
Figure 2.
(A) Patients with healthcare associated infections (HCAI) as a proportion of those at-risk at each monthly surveillance time-point, January–December 2011. (B) Healthcare associated infection case mix observed at each monthly time-point. The total number of patients at-risk at each monthly time-point is expressed above each bar; hospital-acquired pneumonias (HAP); urinary tract infection (UTI); ventilator-associated pneumonia (VAP); skin/soft tissue infection (SSTI). (B) Healthcare associated infection case mix observed at each monthly time-point. The total number of patients at-risk at each monthly time-point is expressed above each bar. HAP: hospital-acquired pneumonias; SSTI: ; UTI: urinary tract infection; VAP: ventilator-associated pneumonia.
Figure 3.
Figure 3.
Hand hygiene audit results, June–December 2011.
See this image and copyright information in PMC

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