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National Survey of Thai Infectious Disease Physicians on Treatment of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia: The Role of Infection Control Awareness

Published online by Cambridge University Press:  29 October 2015

Aubonphan Buppajarntham ,
Anucha Apisarnthanarak ,
Thana Khawcharoenporn ,
Sasinuch Rutjanawech  and
Nalini Singh
Aubonphan Buppajarntham
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Thana Khawcharoenporn
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Sasinuch Rutjanawech
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Nalini Singh
Affiliation:
Division of Infectious Diseases, Children’s National Medical Center, Department of Pediatrics, Epidemiology and Global Health, George Washington University, School of Medicine and Health Sciences, School of Public Health, Washington DC, United States
*
Address correspondence to Anucha Apisarnthanarak, MD, Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand, 10120 (anapisarn@yahoo.com).
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Abstract

OBJECTIVE

To evaluate the expected and treatment outcomes of Thai infectious disease physicians (IDPs) regarding carbapenem-resistant Acinetobacter baumannii (CRAB) ventilator-associated pneumonia (VAP)

METHODS

From June 1, 2014, to March 1, 2015, survey data regarding the expected and clinical success rates of CRAB VAP treatment were collected from all Thai IDPs. The expected success rate was defined as the expectation of clinical response after CRAB VAP treatment for the given case scenario. Clinical success rate was defined as the overall reported success rate of CRAB VAP treatment based on the clinical practice of each IDP. The expected and clinical success rates were divided into low (<60%), standard (60%–80%), and high (>80%) categories and were then compared with standard clinical response rates archived in the existing literature.

RESULTS

Of 183 total Thai IDPs, 111 (60%) were enrolled in this study. The median expected and clinical success rates were 68% and 58%, respectively. Using multivariate analysis, we determined that working in a hospital that implemented the standard intervention combined with an intensified infection control (IC) intervention for CRAB (adjusted odds ratio [aOR], 3.01; 95% confidence interval [CI], 1.17–7.73; P=.02) was associated with standard and high expected rates (>60%). Being a board-certified IDP (aOR, 5.76; 95% CI, 2.16–15.37; P<.01) and having higher number of ID consultation cases per month (aOR, 4.84; 95% CI, 1.98–11.80; P<.01) were associated with standard and high clinical success rates (>60%). We identified a significant correlation between expected and clinical success rates (r=0.58; P<.001).

CONCLUSIONS

Awareness of IC among IDPs can improve physicians’ expected and clinical success rates for CRAB VAP treatment, and treatment experience impacts overall treatment success.

Infect. Control Hosp. Epidemiol. 2015;37(1):61–69

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Supplement 1 , January 2016 , pp. 61 - 69
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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