675. Preventing Catheter-Associated Bloodstream Infection in Thailand
Session: Poster Abstract Session: Preventing Catheter Associated Infections
Friday, October 21, 2011
Room: Poster Hall B1
Background: Central line-associated bloodstream infection (CLABSI) is the third most common nosocomial infection in Thailand.  However, national data describing CLABSI prevention practices have not previously been systematically collected from Thai hospitals. We thus performed a national study to evaluate the current practices used by hospitals in Thailand to prevent CLABSI.

Methods: Between 1 January 2010 and 31 October 2010 data was collected from all hospitals in Thailand with an intensive care unit and > 250 hospital beds (n = 256).  The survey asked about hospital characteristics, as well as practices to prevent CLABSI and other device-associated infections. Logistic regression was used to assess relationships between hospital characteristics and regular use of select CLABSI prevention practices. 

Results: A total of 204 hospitals responded, yielding a response rate of 80%. Regular use of prevention practices were reported as follows: alcohol-based hand rub (93%); avoiding routine central catheter changes (85%); maximum sterile barrier precautions (62%); chlorhexidine gluconate for insertion site antisepsis (38%); antimicrobial dressing with chlorhexidine (24%); and antimicrobial catheters (5%). Only 6% of hospitals reported regular use of all of the elements of the recommended bundle of care (maximum sterile barrier precautions, chlorhexidine gluconate for antisepsis, avoiding routine central catheter changes, antimicrobial dressing with chlorhexidine, and alcohol-based hand rub). Hospitals that used peripherally-inserted central catheters (PICCs) and hospitals with PICC insertion teams were significantly more likely to report regular use of maximum sterile barrier precautions (p = 0.003 and p = 0.002, respectively) and antimicrobial dressing with chlorhexidine (p = 0.034 and p = 0.002, respectively).

Conclusion: Although CLABSI remains common in Thai hospitals, our data indicate that certain prevention practices are used infrequently and most hospitals were not using the complete recommended bundle of care. The importance of PICC insertion teams and the CLABSI bundle should be emphasized as part of continuous education to emphasize basic infection prevention practices to enhance the safety of patients in Thailand. 


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Anucha Apisarnthanarak, MD1, Todd Greene, PhD, MPH2,3, Edward Kennedy, MS2, Thana Khawcharoenporn, MD1, Sarah Krein, PhD, RN2,3,4 and Sanjay Saint, MD, MPH2,3,4, (1)Thammasat University, Pathumthani, Thailand, (2)Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, MI, (3)The University of Michigan Health System, Ann Arbor, MI, (4)Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI

Disclosures:

A. Apisarnthanarak, None

T. Greene, None

E. Kennedy, None

T. Khawcharoenporn, None

S. Krein, None

S. Saint, None

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