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. 2024 Jun 18:48:101120.
doi: 10.1016/j.lanwpc.2024.101120. eCollection 2024 Jul.

Healthcare-associated infections and antimicrobial use at a major referral hospital in Papua New Guinea: a point prevalence survey

Stephanie J Curtis  1 , Roland Barnabas  2 , Kelly A Cairns  1   3 , Donna Cameron  4 , Benjamin Coghlan  5 , Robert Jones  2 , Jacklyn Joseph  2 , Alu Kali  2 , Dimitri Kep  2 , Gemma Klintworth  1 , Stephanie Levy  5 , Matt Mason  6 , Majella Norrie  2 , Trisha Peel  1 , Gilam Tamolsaian  5 , Josephine Telenge  2 , Nellie Tumu  2 , Andrew J Stewardson  1 , Gabriella Ak  2 ; COMBAT-AMR group
Collaborators, Affiliations

Healthcare-associated infections and antimicrobial use at a major referral hospital in Papua New Guinea: a point prevalence survey

Stephanie J Curtis et al. Lancet Reg Health West Pac. .

Abstract

Background: Healthcare-associated infections (HAI) and antimicrobial use (AMU) are drivers for antimicrobial resistance, and robust data are required to inform interventions and track changes. We aimed to estimate the prevalence of HAI and AMU at Port Moresby General Hospital (PMGH), the largest hospital in Papua New Guinea.

Methods: We did a point prevalence survey (PPS) on HAI and AMU at PMGH in May 2023 using the European Centre for Disease Prevention and Control (ECDC) PPS protocol. We included all critical care patients and randomly sampled half of the patients in other acute-care wards. We calculated weighted HAI and AMU prevalence estimates to account for this sampling strategy. Weighted HAI estimates were also calculated for an expanded definition that included physician diagnosis.

Findings: Of 361 patients surveyed in 18 wards, the ECDC protocol identified 28 HAIs in 26 patients, resulting in a weighted HAI prevalence of 6.7% (95% CI: 4.6, 9.8). Surgical site infections (9/28, 32%) were the most common HAI. When adding physician diagnosis to the ECDC definitions, more skin and soft tissue, respiratory, and bloodstream HAIs were detected, and the weighted HAI prevalence was 12.4% (95% CI: 9.4, 16.3). The prevalence of AMU was 66.5% (95%CI: 61.3, 71.2), and 73.2% (263/359) of antibiotics were from the World Health Organization Access group.

Interpretation: This is the first reported hospital PPS of HAI and AMU in Papua New Guinea. These results can be used to prioritise interventions, and as a baseline against which future point prevalence surveys can be compared.

Funding: Australian Government Department of Foreign Affairs and Trade and Therapeutic Guidelines Limited Australia.

Keywords: Antimicrobial use; Healthcare associated infection; Infection prevention; Papua New Guinea; Point prevalence study; Surveillance.

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Conflict of interest statement

There are none to declare relevant to this work. TP is the recipient of a Medical Research Future Fund grant [GNT2014635] and is a Board Director for the Australasian Clinical Trial Alliance. KC receives royalties from UpToDate as co-author of chapter “Daptomycin: An overview”, and their workplace has been paid Honoraria for presentations.

Figures

Fig. 1
Fig. 1
Healthcare-associated infections at port moresby general hospital identified by the European Centre for Disease Prevention and Control point prevalence survey protocol.
See this image and copyright information in PMC

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