512. Healthcare-Associated Infections in Vietnam, 2007: Epidemiology and Risk Factors
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: after the Ministry of Health of Vietnam deemed healthcare-associated infections (HAI) a national priority in 1997, HAI surveillance programs were initiated. However, HAI data have neither been aggregated systematically nor based on validated HAI case definitions. We conducted this study to (i) characterize HAI in Vietnam using standardized HAI definitions, and (ii) identify risk factors associated with HAI.
Methods: in 2007, we conducted a one-day cross-sectional survey of HAI in 36 hospitals across Vietnam. These hospitals represented different levels of care, ranging from district hospitals to tertiary care, multispecialty facilities. HAI were ascertained using modifications of HAI surveillance definitions established by the Centers for Disease Control and Prevention, USA. We calculated crude rates and carried out multivariate analyses using logistic regression.
Results: of 7,571 patients assessed in the survey, 553 (7.3%) acquired ≥1 HAI. A total of 590 HAI were ascertained (i.e., 7.8% crude HAI rate). The most common HAI were pneumonia (41.9%), surgical wound infections (27.5%), and gastrointestinal infections (13.1%). Independent risk factors for HAI are outlined in the table:
Infection siteIndependent risk factorsAdjusted odds ratiop-value
Respiratory tractEndotracheal intubation
Tracheotomy
1.6
10.9
<0.01
<0.01
Urinary tractIndwelling catheter2.6<0.01
BloodstreamCentral venous catheter2.6<0.01

Independent risks for any type of HAI included surgery (OR = 3.5; p <0.01); admission to the intensive care unit (OR = 14.0; p <0.05), pediatric unit (OR = 15.2, p < 0.01); or surgery unit (OR = 3.9; p <0.01); or admission to provincial level hospitals (OR = 1.5; p <0.01). The microorganisms most commonly implicated were Pseudomonas aeruginosa (31.5%), Acinetobacter baumanii (23.3%), and Candida spp. (14.4%).
Conclusion: These data indicate that HAIs cause substantial morbidity in Vietnam, and that gram-negative pathogens are commonly implicated. Risk factors are largely associated invasive medical devices or procedures. Our data indicate an urgent need for a nationwide HAI surveillance system in Vietnam using validated HAI case definitions.
Truong Anh Thu, MD, MPH1, Lennox Archibald, MD, PhD2, Pham Duc Muc, MD, MPH3, Nguyen Ngo Quang, MD, MPH3, Li Thi Thanh Thuy, MD1, Nguyen Viet Hung, MD, PhD1 and  T. Anh Thu, None..
L. Thanh Thuy, None..
N. Viet Hung, None..
P. Duc Muc, None..
N. Ngo Quang, None. 
L. K. Archibald,
RTI Biologics Role(s): Other, Medical Director, Received: Salary., (1)Bach Mai Hospital, Hanoi, Viet Nam, (2)College of Medicine, University of Florida, Gainesville, FL, (3)Ministry of Health, Hanoi, Viet Nam