The Study of Antimicrobial Resistance (AMR) and ESKAPE Bacteria Have Been Reported In -Healthcare Associated Bloodstream Infections (HA-BSI) by WHONET Program in Nopparat Rajathanee Hospital, 2017-2018
Keywords:Antimicrobial resistance, AMR, Nopparat Rajathanee Hospital, HA-BSI, ESKAPE, MDR, CRE, VRE
Background : Antimicrobial resistance (AMR) is the leading cause of Healthcare-associated infections (HAIs) throughout the world. The mostly AMR is ESKAPE bacteria. Effects include high mortality and morbidity rates. Effective surveillance & response for AMR might be prevented and responded to HAIs and Outbreaks with AMR.
Objective : This study was to explore the situation of antimicrobial resistance and ESKAPE bacteria in patients with bloodstream infection.
Method : Medical records of hospitalized patients during January 2017 to December 2018 who had at least one of positive blood cultures were reviewed by the infection control nurse team. The surveillance reports of Healthcareassociated blood stream infection (HA-BSI) was matched pair with the results of the positive blood cultures to analyses the situation of them.
Results : The WHO-NET program could be help with easier and faster data analysis. A total of 1,862 patients with a positive blood cultures were reviewed and found Staphylococcus coagulase negative were the most bacteria during two years. The ESKAPE bacteria met 447 patients (24.0%) which 23.3% (104/447) met multidrug resistance (MDR), 2.8% (17/607) met carbapenem resistance Enterobacteriaceae (CRE) and 3.6% (2/56) met vancomycin resistance Enterococcus (VRE). The proportion of Enterococcus BSI case that was resistance to vancomycin was 1.3% (1/79) which is Central-line associated blood stream infection. The proportion of Klebsiella pneumonia BSI case that was resistant to carbapenem was 7.6% (6/79) which is a Central-line associated blood stream infection were 66.7% (4/6).
Conclusions : Escherichia coli was the most pathogens of HA-BSI (10/79) which 50.0 % (5/10) met antimicrobial resistance. However, 43% (34/79) of HA-BSI is ESKAPE bacteria which 41.2% (14/34) met antimicrobial resistance. Moreover, 64.3% (9/14) of ESKAPE antimicrobial resistance is Central-line associated blood stream infection. These data are the baseline for decrease AMR which response to the policy of the Government. These will be beneficial adapt to multimodal for decreasing the HA-BSI.
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