Practices to prevent multidrug-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in Thailand: A national survey

Abstract

Multidrug-resistant organisms (MDRO) are increasing challenges for health care institutions worldwide, and there are many factors associated with their distribution. We conducted a national survey of Thai hospitals with 1 or more intensive care units and ≥250 hospital beds to evaluate hospital characteristics and current practices to minimize the endemic burden of multidrug-resistant (MDR) Acinetobacter baumannii (AB) and methicillin-resistant Staphylococcus aureus (MRSA). Research nurses collected survey data from participating hospitals between January 1 and April 30, 2011. Data collection focused on hospital characteristics and practices to prevent endemic MDR-AB and MRSA; logistic regression analyses were used to assess associations between hospital characteristics and infection prevention control (IPC) interventions. There was an 80% survey response (N = 204) from 256 eligible hospitals. Endemic MDR-AB and MRSA were reported in 184 (90%) and 100 (40%) hospitals, respectively. The most frequently reported IPC interventions were contact isolation, hand hygiene campaigns, and antimicrobial stewardship; active surveillance, chlorhexidine gluconate bathing, and multifaceted interventions were uncommon. By multivariate analysis, having a physician as the lead infection control professional and participation in a collaborative effort to prevent MDR organisms were associated with multifaceted interventions to reduce MDR-AB, and medical school affiliation and participating in a collaborative effort to prevent MDR organisms were associated with multifaceted interventions to reduce MRSA. Multifaceted interventions to reduce, if not prevent, MDR-AB and MRSA were infrequently reported from Thai hospitals. Our survey findings provide baseline data for IPC interventions for MDR-AB and MRSA. Future efforts that correlate IPC interventions and MDRO trends will help develop evidence-based practices in these resource-limited settings.