• Ngai Kien Le, Wertheim Hf, Phu Dinh Vu, Dung Thi Khanh Khu, LeHai ThanhHT, Bich Thi Ngoc Hoang, Vu Thanh Vo, Yen Minh Lam, Dung Tien Viet Vu, Thu Hoai Nguyen, Tung Quang Thai, Lennart E Nilsson, Ulf Rydell, NguyenKinh VanKV, Behzad Nadjm, Louise Clarkson, Håkan Hanberger, and Mattias Larsson.
• National Hospital of Pediatrics, Hanoi Oxford University Clinical Research Unit, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, UK Department of Medical Microbiology, RCI, Radboudumc, Nijmegen, Netherlands National Hospital for Tropical Diseases, Hanoi Children's Hospital 1, HCMC Hospital for Tropical Diseases, HCMC Linköping University, Sweden Karolinska Institutet, Stockholm, Sweden.
• Medicine (Baltimore). 2016 Jul 1; 95 (27): e4099e4099.

AbstractThere is scarce information regarding hospital-acquired infections (HAIs) among children in resource-constrained settings. This study aims to measure prevalence of HAIs in Vietnamese pediatric hospitals.Monthly point prevalence surveys (PPSs) in 6 pediatric intensive care units (ICUs) in 3 referral hospitals during 1 year.A total of 1363 cases (1143 children) were surveyed, 59.9% male, average age 11 months. Admission sources were: other hospital 49.3%, current hospital 36.5%, and community 15.3%. Reasons for admission were: infectious disease (66%), noninfectious (20.8%), and surgery/trauma (11.3%). Intubation rate was 47.8%, central venous catheter 29.4%, peripheral venous catheter 86.2%, urinary catheter 14.6%, and hemodialysis/filtration 1.7%. HAI was diagnosed in 33.1% of the cases: pneumonia (52.2%), septicemia (26.4%), surgical site infection (2%), and necrotizing enterocolitis (2%). Significant risk factors for HAI included age under 7 months, intubation and infection at admission. Microbiological findings were reported in 212 cases (43%) with 276 isolates: 50 Klebsiella pneumoniae, 46 Pseudomonas aeruginosa, and 39 Acinetobacter baumannii, with carbapenem resistance detected in 55%, 71%, and 65%, respectively. Staphylococcus aureus was cultured in 18 cases, with 81% methicillin-resistant Staphylococcus aureus. Most children (87.6%) received antibiotics, with an average of 1.6 antibiotics per case. Colistin was administered to 96 patients, 93% with HAI and 49% with culture confirmed carbapenem resistance.The high prevalence of HAI with carbapenem resistant gram-negative strains and common treatment with broad-spectrum antibiotics and colistin suggests that interventions are needed to prevent HAI and to optimize antibiotic use.

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