Healthcare-associated infections and antimicrobial use at a major referral hospital in Papua New Guinea: a point prevalence survey.
Antimicrobial use
Healthcare associated infection
Infection prevention
Papua New Guinea
Point prevalence study
Surveillance
Journal
The Lancet regional health. Western Pacific
ISSN: 2666-6065
Titre abrégé: Lancet Reg Health West Pac
Pays: England
ID NLM: 101774968
Informations de publication
Date de publication:
Jul 2024
Jul 2024
Historique:
received:
21
03
2024
revised:
24
05
2024
accepted:
31
05
2024
medline:
12
7
2024
pubmed:
12
7
2024
entrez:
12
7
2024
Statut:
epublish
Résumé
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. 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. 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. 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. Australian Government Department of Foreign Affairs and Trade and Therapeutic Guidelines Limited Australia.
Sections du résumé
Background
UNASSIGNED
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
UNASSIGNED
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
UNASSIGNED
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
UNASSIGNED
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
UNASSIGNED
Australian Government Department of Foreign Affairs and Trade and Therapeutic Guidelines Limited Australia.
Identifiants
pubmed: 38993540
doi: 10.1016/j.lanwpc.2024.101120
pii: S2666-6065(24)00114-7
pmc: PMC11238180
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101120Investigateurs
Benjamin Thomas
(B)
Cassius Maingu
(C)
Dellyne Polly
(D)
Hans Nogua
(H)
Jessica Mondowa
(J)
Joe Sokal
(J)
Josen Yem
(J)
Joyce Lawrence
(J)
Mathilda Rarah
(M)
Rose Olwont
(R)
Rupert Marcus
(R)
Saberina Silas
(S)
Stephanie Kialo-Davis
(S)
Alison Macintyre
(A)
Philip Russo
(P)
Rosaleen Kehoe
(R)
Informations de copyright
© 2024 The Author(s).
Déclaration de conflit d'intérêts
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.