Abstract
BackgroundSustainable systematic interventions are important for infection prevention and control (IPC). Data from surveillance of healthcare-associated infections (HAI) provides feedback for implementation of IPC programs. To address the paucity of such data in Asia, we searched for national HAI surveillance and IPC programs in this region.MethodsData were analysed from open access national surveillance reports of three Asian countries: Taiwan, South Korea and Japan from 2008 to 2015. National IPC programs were identified.ResultsThere were differences among the countries in surveillance protocols, hospital coverage rates, and national IPC policies and programs. Nevertheless, there was a 53.0% reduction in overall HAI over the 8-year period. This consisted of a decrease from 9.34 to 5.03 infections per 1000 patient-days in Taiwan, from 7.56 to 2.76 in Korea, and from 4.41 to 2.74 in Japan (Poisson regression, all p < 0.05). Across the three countries, Escherichia coli and Candida albicans were the major pathogens for urinary tract infection. Staphylococcus aureus, Acinetobacter baumannii and Enterococcus faecium were common bloodstream pathogens. For pneumonia, S. aureus, A. baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the predominant pathogens, with considerable country differences. There was a 64.6% decrease in the number of isolates of methicillin-resistant S. aureus, 38.4% decrease in carbapenem-resistant P. aeruginosa and 49.2% decrease in carbapenem-resistant A. baumannii (CRAB) in Taiwan (all p < 0.05), and similarly in Korea with the exception of CRAB (30.5 and 50.4% reduction, respectively, both p < 0.05).ConclusionWe found a significant decrease in HAI across the three countries in association with sequential multifaceted interventions such as hand hygiene, care bundles, and antimicrobial stewardships. Further regional collaboration could be forged to develop joint strategies to prevent HAI.
Highlights
Sustainable systematic interventions are important for infection prevention and control (IPC)
healthcare-associated infections (HAI) data are stratified by infection site: urinary tract infection (UTI), bloodstream infection (BSI), hospital-acquired pneumonia (HAP); by device-use: catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP); and by type of hospital
Characteristics of Taiwan, South Korea and Japan’s National Surveillance Systems The characteristics of the national HAI surveillance systems of Taiwan, South Korea, and Japan are summarised in Table 1 [6, 8, 11]
Summary
Sustainable systematic interventions are important for infection prevention and control (IPC). Data from surveillance of healthcare-associated infections (HAI) provides feedback for implementation of IPC programs. To address the paucity of such data in Asia, we searched for national HAI surveillance and IPC programs in this region. By centralizing data on antimicrobial use, HAI incidence, and HAI point prevalence, HAI-net builds a regional landscape that allows inter-country comparison and provides feedback for implementation of regional infection prevention and control (IPC) guidelines [1]. The present study is based on data derived from open access reports from the surveillance systems of these countries. They include temporal trends of HAI in intensive care units (ICUs), the major causative pathogens and antimicrobial resistance (AMR). Implemented IPC policies were reviewed to gain insights on important interventions instituted in these three countries
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