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Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022
To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand. We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry...
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| Published in: | The Journal of infection 2024-10, Vol.89 (4), p.106249, Article 106249 |
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| container_issue | 4 |
| container_start_page | 106249 |
| container_title | The Journal of infection |
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| creator | Tuamsuwan, Krittiya Chamawan, Panida Boonyarit, Phairam Srisuphan, Voranadda Klaytong, Preeyarach Rangsiwutisak, Chalida Wannapinij, Prapass Fongthong, Trithep Stelling, John Turner, Paul Limmathurotsakul, Direk |
| description | To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand.
We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used.
The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52–2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size.
The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.
•The frequency of AMR BSI in 111 public hospitals in Thailand in 2022 was studied.•The frequency of community-origin 3GCREC BSI was different by regions.•The frequency of hospital-origin CRAB BSI varied greatly among hospitals.•Underuse of BC was associated with the higher frequency of AMR BSI per tested patients.•Our findings contributed to actions against AMR at local and national levels. |
| doi_str_mv | 10.1016/j.jinf.2024.106249 |
| format | article |
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We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used.
The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52–2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size.
The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.
•The frequency of AMR BSI in 111 public hospitals in Thailand in 2022 was studied.•The frequency of community-origin 3GCREC BSI was different by regions.•The frequency of hospital-origin CRAB BSI varied greatly among hospitals.•Underuse of BC was associated with the higher frequency of AMR BSI per tested patients.•Our findings contributed to actions against AMR at local and national levels.</description><identifier>ISSN: 0163-4453</identifier><identifier>ISSN: 1532-2742</identifier><identifier>EISSN: 1532-2742</identifier><identifier>DOI: 10.1016/j.jinf.2024.106249</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>Antimicrobial resistant ; Bloodstream infection ; Frequency ; Incidence ; Proportion ; Surveillance</subject><ispartof>The Journal of infection, 2024-10, Vol.89 (4), p.106249, Article 106249</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c258t-66ef3be4b08545da630d29288edb942b726b1e4d4427256be8093a7e263c70ea3</cites><orcidid>0009-0007-9380-9085 ; 0000-0002-1013-7815</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids></links><search><creatorcontrib>Tuamsuwan, Krittiya</creatorcontrib><creatorcontrib>Chamawan, Panida</creatorcontrib><creatorcontrib>Boonyarit, Phairam</creatorcontrib><creatorcontrib>Srisuphan, Voranadda</creatorcontrib><creatorcontrib>Klaytong, Preeyarach</creatorcontrib><creatorcontrib>Rangsiwutisak, Chalida</creatorcontrib><creatorcontrib>Wannapinij, Prapass</creatorcontrib><creatorcontrib>Fongthong, Trithep</creatorcontrib><creatorcontrib>Stelling, John</creatorcontrib><creatorcontrib>Turner, Paul</creatorcontrib><creatorcontrib>Limmathurotsakul, Direk</creatorcontrib><title>Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022</title><title>The Journal of infection</title><description>To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand.
We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used.
The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52–2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size.
The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.
•The frequency of AMR BSI in 111 public hospitals in Thailand in 2022 was studied.•The frequency of community-origin 3GCREC BSI was different by regions.•The frequency of hospital-origin CRAB BSI varied greatly among hospitals.•Underuse of BC was associated with the higher frequency of AMR BSI per tested patients.•Our findings contributed to actions against AMR at local and national levels.</description><subject>Antimicrobial resistant</subject><subject>Bloodstream infection</subject><subject>Frequency</subject><subject>Incidence</subject><subject>Proportion</subject><subject>Surveillance</subject><issn>0163-4453</issn><issn>1532-2742</issn><issn>1532-2742</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kDFPwzAQhS0EEqXwB5gyMpBinx0nkVhQRQGpEktZsez4ojpK4mKnSP33uJSZydbze753HyG3jC4YZfKhW3RubBdAQSRBgqjPyIwVHHIoBZyTWTLxXIiCX5KrGDtKac1rOSOfq4BfexybQ-bbTI-TG1wTvHG6zwNGF6ekZab33sYpoB6yNAebyfkxpmvGGMu2Pu7cpPtfYbPVrtejvc9SGbgmF216wJu_c04-Vs-b5Wu-fn95Wz6t8waKasqlxJYbFIZWhSislpxaqKGq0JpagClBGobCCgElFNJglerrEkHypqSo-Zzcnf7dBZ_WiZMaXGywT03Q76PitJZQViWrkhVO1rRmjAFbtQtu0OGgGFVHmKpTR5jqCFOdYKbQ4ymEaYlvh0HFxiVqaF1INJT17r_4DyiLfM8</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Tuamsuwan, Krittiya</creator><creator>Chamawan, Panida</creator><creator>Boonyarit, Phairam</creator><creator>Srisuphan, Voranadda</creator><creator>Klaytong, Preeyarach</creator><creator>Rangsiwutisak, Chalida</creator><creator>Wannapinij, Prapass</creator><creator>Fongthong, Trithep</creator><creator>Stelling, John</creator><creator>Turner, Paul</creator><creator>Limmathurotsakul, Direk</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0007-9380-9085</orcidid><orcidid>https://orcid.org/0000-0002-1013-7815</orcidid></search><sort><creationdate>20241001</creationdate><title>Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022</title><author>Tuamsuwan, Krittiya ; Chamawan, Panida ; Boonyarit, Phairam ; Srisuphan, Voranadda ; Klaytong, Preeyarach ; Rangsiwutisak, Chalida ; Wannapinij, Prapass ; Fongthong, Trithep ; Stelling, John ; Turner, Paul ; Limmathurotsakul, Direk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c258t-66ef3be4b08545da630d29288edb942b726b1e4d4427256be8093a7e263c70ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antimicrobial resistant</topic><topic>Bloodstream infection</topic><topic>Frequency</topic><topic>Incidence</topic><topic>Proportion</topic><topic>Surveillance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tuamsuwan, Krittiya</creatorcontrib><creatorcontrib>Chamawan, Panida</creatorcontrib><creatorcontrib>Boonyarit, Phairam</creatorcontrib><creatorcontrib>Srisuphan, Voranadda</creatorcontrib><creatorcontrib>Klaytong, Preeyarach</creatorcontrib><creatorcontrib>Rangsiwutisak, Chalida</creatorcontrib><creatorcontrib>Wannapinij, Prapass</creatorcontrib><creatorcontrib>Fongthong, Trithep</creatorcontrib><creatorcontrib>Stelling, John</creatorcontrib><creatorcontrib>Turner, Paul</creatorcontrib><creatorcontrib>Limmathurotsakul, Direk</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tuamsuwan, Krittiya</au><au>Chamawan, Panida</au><au>Boonyarit, Phairam</au><au>Srisuphan, Voranadda</au><au>Klaytong, Preeyarach</au><au>Rangsiwutisak, Chalida</au><au>Wannapinij, Prapass</au><au>Fongthong, Trithep</au><au>Stelling, John</au><au>Turner, Paul</au><au>Limmathurotsakul, Direk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022</atitle><jtitle>The Journal of infection</jtitle><date>2024-10-01</date><risdate>2024</risdate><volume>89</volume><issue>4</issue><spage>106249</spage><pages>106249-</pages><artnum>106249</artnum><issn>0163-4453</issn><issn>1532-2742</issn><eissn>1532-2742</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand.
We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used.
The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52–2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size.
The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.
•The frequency of AMR BSI in 111 public hospitals in Thailand in 2022 was studied.•The frequency of community-origin 3GCREC BSI was different by regions.•The frequency of hospital-origin CRAB BSI varied greatly among hospitals.•Underuse of BC was associated with the higher frequency of AMR BSI per tested patients.•Our findings contributed to actions against AMR at local and national levels.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.jinf.2024.106249</doi><orcidid>https://orcid.org/0009-0007-9380-9085</orcidid><orcidid>https://orcid.org/0000-0002-1013-7815</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antimicrobial resistant Bloodstream infection Frequency Incidence Proportion Surveillance |
| title | Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022 |
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