Prevalence and impacts of nosocomial infection in Thailand 2001.

ABSTRACT

OBJECTIVES: To study the prevalence and impacts of nosocomial infection (N.I.) in Thailand. MATERIAL AND METHOD: A point prevalence study on N.I. was carried out in 42 hospitals across Thailand in March 2001. The impacts of N.I. were done in the same hospitals by matched control groups in a period prevalence study March 12-25, 2001. RESULTS: The point prevalence rate of N.I. in 42 hospitals involving 18,456 patients across Thailand in March 2001 was 6.4%. The prevalence was higher in male than female patients (7.8% vs 5.0%). The prevalence rates of over 10% were found in 4 hospitals. The infection rate was highest in surgical followed in rank by medical, pediatric and orthopedic departments (9.1%, 7.6%, 6.1% and 5.8%) respectively. The commonest site of the infection was the lower respiratory tract, followed by urinary tract, surgical site and skin and soft tissue (34.1%, 21.5%, 15.0% and 10.5%). Gram-negative bacteria were isolated in 75.3% and gram-postive 18.4%. Penicillins, cephalosporins, aminoglycosides were the most used antimicrobials (31.2%, 25.2%, 12.3%). A period prevalence study on 53,882 patients during a 2 week period in March 2001 showed an infection rate of 2.5%. By matched control group study, an episode of N.I. was associated with 10.1 to 12.5 extra hospital days. The cost of antimicrobials for treatment of an episode of N.I. was 5919.50 baht (148 U.S. dollars). Thirteen point eight per cent of patients with N.I. died, 6.7% directly due to N.I. CONCLUSION: Nosocomial infection is common in hospitalized patients in Thailand and is associated high mortality rate and economic burden.