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. 2017 May 15;64(suppl_2):S61-S67.
doi: 10.1093/cid/cix103.

Prevalence of Healthcare-Associated Infections and Antimicrobial Use Among Adult Inpatients in Singapore Acute-Care Hospitals: Results From the First National Point Prevalence Survey

Yiying Cai  1   2 , Indumathi Venkatachalam  3 , Nancy W Tee  4 , Thean Yen Tan  5 , Asok Kurup  6 , Sin Yew Wong  7 , Chian Yong Low  8 , Yang Wang  9 , Winnie Lee  1 , Yi Xin Liew  1 , Brenda Ang  10 , David C Lye  10 , Angela Chow  11   12 , Moi Lin Ling  13 , Helen M Oh  14 , Cassandra A Cuvin  9 , Say Tat Ooi  15 , Surinder K Pada  16 , Chong Hee Lim  17 , Jack Wei Chieh Tan  18 , Kean Lee Chew  19 , Van Hai Nguyen  20 , Dale A Fisher  21   22 , Herman Goossens  23 , Andrea L Kwa  1   2   24 , Paul A Tambyah  21   22 , Li Yang Hsu  10   12 , Kalisvar Marimuthu  10   22
Affiliations

Prevalence of Healthcare-Associated Infections and Antimicrobial Use Among Adult Inpatients in Singapore Acute-Care Hospitals: Results From the First National Point Prevalence Survey

Yiying Cai et al. Clin Infect Dis. .

Abstract

Background: We conducted a national point prevalence survey (PPS) to determine the prevalence of healthcare-associated infections (HAIs) and antimicrobial use (AMU) in Singapore acute-care hospitals.

Methods: Trained personnel collected HAI, AMU, and baseline hospital- and patient-level data of adult inpatients from 13 private and public acute-care hospitals between July 2015 and February 2016, using the PPS methodology developed by the European Centre for Disease Prevention and Control. Factors independently associated with HAIs were determined using multivariable regression.

Results: Of the 5415 patients surveyed, there were 646 patients (11.9%; 95% confidence interval [CI], 11.1%-12.8%) with 727 distinct HAIs, of which 331 (45.5%) were culture positive. The most common HAIs were unspecified clinical sepsis (25.5%) and pneumonia (24.8%). Staphylococcus aureus (12.9%) and Pseudomonas aeruginosa (11.5%) were the most common pathogens implicated in HAIs. Carbapenem nonsusceptibility rates were highest in Acinetobacter species (71.9%) and P. aeruginosa (23.6%). Male sex, increasing age, surgery during current hospitalization, and presence of central venous or urinary catheters were independently associated with HAIs. A total of 2762 (51.0%; 95% CI, 49.7%-52.3%) patients were on 3611 systemic antimicrobial agents; 462 (12.8%) were prescribed for surgical prophylaxis and 2997 (83.0%) were prescribed for treatment. Amoxicillin/clavulanate was the most frequently prescribed (24.6%) antimicrobial agent.

Conclusions: This survey suggested a high prevalence of HAIs and AMU in Singapore's acute-care hospitals. While further research is necessary to understand the causes and costs of HAIs and AMU in Singapore, repeated PPSs over the next decade will be useful to gauge progress at controlling HAIs and AMU.

Keywords: antimicrobial prescribing practices; healthcare-associated infections; point prevalence survey..

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