Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

Original Research

Abstract

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

Graphical abstract

Isolation of Lactic acid bacteria showing antagonistic activity against Streptococcus mutans

Original Research

Abstract

Background and Objectives: Streptococcus mutans is a major pathogen that initiates dental plaque and dental caries due to its strong acid production and biofilm-forming ability. Recent studies showed that lactic acid bacteria (LAB), exert useful properties which make them become potential tools to fight against S. mutans and its relating diseases. The current study aimed to isolate and screen for LAB strains that could inhibit S. mutans growth as well as its biofilm production.

Methods and Results: Using the spread plate technique, fifty-one LAB strains were isolated from fermented vegetables and healthy human saliva. From that, fourteen isolates showed the inhibitory effect on S. mutans growth in well-diffusion assay. These strains were then screened on the ability in reducing S. mutans biofilm formation by colorimetric assay. Next, potential LAB was evaluated on some probiotic characteristics including saliva amylase tolerance, acid tolerance, bile tolerance as well as antibiotic susceptibility properties. As a result, four strains showed the most promising features were further tested for the ability to reduce Streptococcus mutans biofilm by scanning electron microscopy (SEM) observation and by expression analysis of biofilm-forming genes (gtfB and luxS) using RT-qPCR method. Finally, these four strains were identified to species level using API® 50 CHL kit and 16S rDNA sequencing method. The result showed that two strains belong to L. plantarums, one belongs to L. brevis and the other is Weisella confusa

Conclusion: This study was successful in isolating LAB that showed promising probiotic effects against S. mutans.

Graphical abstract

Prevalence and risk factors of Ureplasma urealyticum and Mycoplasma genitalium among women with secondary infertility in Vietnam – A cross-sectional study

Clinical Article

Abstract

Introduction: Ureaplasma urealyticum and Mycoplasma genitalium are infectious pathogens resulting in non-gonococcal urethritis and complications such as pelvic inflammatory disease (PID) and infertility. This study aimed to determine the prevalence of U. urealyticum and M. genitalium in women with secondary infertility and the related factors to these infections.

Methods: This cross-sectional descriptive study was carried out from July 2017 to June 2018. Cervical specimens were collected from women with secondary infertility at the Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Vietnam. PCR was applied for detection of U. urealyticum and M. genitalium. Tubal patency was assessed by hysterosalpingography.

Results: Prevalence of U. urealyticum and M. genitalium were 37.9% and 2.1%, respectively. The association was not statistically significant among infection and the following factors like age, educational level, occupation, history of miscarriage, history of genital infection and abdominal surgery, or infertility duration (p > 0.05). There was a statistically significant correlation between U. urealyticum infection and tubal damage according to hysterosalpingography (p < 0.05).

Conclusion: In the case of women with secondary infertility, genital infection with M. genitalium was rare, whereas that with U. urealyticum infection was high and appeared to be associated with tubal damage.

Graphical abstract

Validation of predictive equations against DXA for estimation of body fat composition in Vietnamese children

Original Research

Abstract

Background: Childhood overweight and obesity are becoming more pronounced in Vietnam, so an assessment tool of high efficiency in the community is warranted. This study sought to validate skinfold thickness (SFT) equations for estimation of body fatness by Goran and Slaughter against DXA to aid in assessing obesity.

Method: A cross-sectional study was conducted on 144 healthy children (ages 6-17) who were conveniently sampled from schools within an urban district. Their anthropometric measurements (height, weight, and SFT) and DXA whole-body results were taken to record body fat percentage (BF%). Bland-Altman analysis and correlation between bias and body fat were employed to understand the agreement between results from each equation and DXA whole body.

Result: BF% was 32.2 ± 7.6% (mean ± SD). 52.8% of the children were overweight or obese. Bland-Altman plots showed that all four SFT equations had wide limits of agreement (LOAs) and largely underestimated the reference BF% by up to 8.90%. Goran equation predicted better when BF% decreased, whereas Slaughter equations produced less bias when there was more body fat.

Conclusion: The prevalence rate of overweight and obesity has become alarming. Besides, Goran and Slaughter equations cannot be used as alternatives for DXA scanning to measure body fat due to their underestimation.

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Hospital-acquired infections in ageing Vietnamese population: current situation and solution

Review

Abstract

Hospital-acquired infection (HAI) is a growing problem all around the world particularly for countries with aging and high-density population such as Vietnam. In this review, we summarized the current status of HAIs in Vietnam regarding types of infection, rates of infection, hospital-stay duration and cost of treatment, and provided an overview with suggestions on strategies in combating these infections especially in Vietnamese settings. From quite dispersed and varied data reported in English and Vietnamese, we have seen HAI rates of less than 10%. Over the years, the HAIs in Vietnam remained quite stable and even slightly decreased in recent years. Among all HAIs, respiratory tract infections are the most common, occurring in up to 80% of cases. Most Vietnamese statistical data on the etiology of HAIs focused on bacterial HAIs, mostly Candidiasis, whereas limited information was found on fungal infections, nosocomial viral and other parasitic infections. The most important HAI causative pathogens in Vietnamese hospitals include Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Candida species. There is absolutely few scientific data, but web-based information on HAIs treatment cost and measures to control the infections were found. Works are reported to be implemented to control HAIs in Vietnam at both national and hospital level. However, further improvement in controlling HAIs in Vietnam should be considered.

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