SG-APSIC1100: Healthcare-associated infections in COVID-19 patients in Vietnam: Are we able to respond better?

Objectives: Studies have revealed that a relatively high incidence of severe infection and mortality in COVID-19 patients is attributed to healthcare-associated infections (HAIs). We implemented a study in 2 field hospitals dedicated to COVID-19 treatment in Da Nang, Vietnam (July–August 2020), and Ho Chi Minh City, Vietnam (August–October 2021), to identify pathogens, risk factors, and outcomes associated with HAIs. Methods: We applied a prospective study tool to estimate HAI incidence among 1,454 patients. HAIs are diagnosed and ascertained using surveillance criteria established by the US Centers for Disease Control and Prevention. All patients hospitalized for COVID-19 for at least 2 days were enrolled in this assessment of HAI risks, pathogens, and outcomes. Results: Among 1,454 sampled patients, 391 patients had 423 HAIs (27.1%). The highest proportion occurred in ICUs, with 422 HAI patients (34.1%). Pneumonia (n = 331, 78.3%) and bloodstream infections (n = 55, 13.1%) were the most common HAIs. Multidrug-resistant (MDR) bacteria, such as Klebsiella pneumonia (27.9%) and Acinetobacter baumannii (25.3%), were the most commonly isolated organisms. Ventilators and central venous catheters were independently associated with HAIs. Regarding the mortality rates, 55% of deaths occurred in intensive care units. Patients with HAIs (70.3%) were twice as likely to die compared to patients without HAIs (38.8%). HAIs leading to septic shock caused almost triple mortality (n = 58, 90.6%) compared with non-HAI patients (n = 412, 38.8%). HAIs prolonged hospital stay: 24.7 days for patients with HAIs and 19.1 days for patients without HAIs (P < .001). Conclusions: Patients with COVID-19–related critical illnesses are at high risk of HAIs from multidrug-resistant (MDR) bacteria. HAIs prolong hospitalization, whereas HAIs with septic shock almost tripled mortality. Guidelines and procedures to prevent and control HAIs caused by MDR bacteria as well as training and monitoring on aseptic-compliant techniques during invasive clinical procedures are needed.

Selectivity of volatile organic compounds on the surface of zinc oxide nanosheets for gas sensors.

The detection of volatile organic compounds by gas sensors is of great interest for environmental quality monitoring and the early-stage and noninvasive diagnosis of diseases. Experiments found hexane, toluene, aniline, butanone, acetone, and propanol gases in the exhaled breath of patients suffering from COVID-19, lung cancer, and diabetes. However, no studies are available to systematically elucidate the selectivity of these gases on nanosheets of zinc oxide for chemiresistive and direct thermoelectric gas sensors. Therefore, this work performed the elucidation by studying the electronic, electrical, and thermal properties of the bilayered ZnO nanosheets with polar (0001) and non-polar (112̄0) surfaces under the adsorption of the gases. The interaction between the gases and the nanosheets belongs to two groups: electrostatic attraction and charge exchange. The second one occurs due to the peak resonance of the same type of orbitals between the substrates and the gases along the surface normal and the first one for the other cases. The characteristics of the Seebeck coefficient exhibited distinct selectivity of butanone and acetone.

The story of critical care in Asia: a narrative review.

BACKGROUND: Asia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia. MAIN BODY: Although the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty. CONCLUSIONS: Critical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.

Prevalence and Factors Associated with Psychological Problems of Healthcare Workforce in Vietnam: Findings from COVID-19 Hotspots in the National Second Wave.

Adopting a cross-sectional study design, we aimed to examine the prevalence of psychological problems in different healthcare workers during the COVID-19 pandemic in the hospitals in these COVID-19 hotspots (Da Nang city and Quang Nam province) and to explore the socioeconomic and COVID-19 control-related factors that are associated with various psychological problems. A total of 611 healthcare workers were included in the final analysis from 1 August 2020 to 31 August 2020. The prevalence of anxiety, depression, insomnia, and overall psychological problems was 26.84%, 34.70%, 34.53%, and 46.48%, respectively. The prevalence rates of anxiety were approximately equal amongst the groups of healthcare workers, and moderate-to-severe anxiety was the most common in physicians (11.11%). The prevalence of depression was the highest in nurses (38.65%) and moderate-to-severe depression was mainly found in physicians (11.81%). The prevalence rates of insomnia were 34.03% in physicians, 36.20% in nurses, and 31.21% in technicians; in particular, the rate of moderate-to-severe insomnia was higher in physicians and nurses compared to technicians. The prevalence of overall moderate-to-severe psychological problems was the highest among physicians (14.58%), followed by nurses (12.58%) and technicians (9.22%). Statistically significant associated factors of current psychological problems were the occupations of physicians or nurses, less than 1 year of experience, university education, living with 4-5 people, reporting 1000-5000 m distance between home and workplace, participating in the COVID-19 control for less than 1 week, being under social isolation at home, being affected a lot by the community, reporting inadequate equipment in current workplace conditions, frequently working in the department directly in contact with the COVID-19 patients, and feeling anxious, stressed, or sad about current works. Present findings can provide valuable evidence for the policymakers and managers to adopt supportive, encouraging, motivational, protective, training, and educational interventions into healthcare workforce in other parts of Vietnam.