Health-care associated infections in Thailand 2011.

OBJECTIVE: To study the recent trend of health-care associated infections (HAIs) across Thailand. MATERIAL AND METHOD: Using the modified international HAI definitions, the investigators conducted a prospective, nationwide, multi-centered survey to determine a 1-day point-prevalence of HAIs among hospitalized patients in the 47 acute care, primary to tertiary hospitals in January 2011. RESULTS: Of total 10,762 patients (female 50.6%, mean age 44.2 +/- 27.3 years) enrolled in the study, 780 had HAIs or the average prevalence of HAIs was 7.3% (range 2.8-8.5%). Highest rates of HAIs were found in other hospitals (other type of tertiary-care facilities), intensive care units and lower respiratory tracts when stratified by type of hospital, unit of service and site of HAIs, respectively. Gram negative bacteria remained predominant among etiologic agents causing HAIs, as in prior studies. Acinetobacter spp., however emerged as the most common organism. At the time of study, 49.3% of all patients received one or more antimicrobial agents. Among the patients with HAIs, cephalosporins were the most commonly used. CONCLUSION: Recently, no significant change on nationwide prevalence and trend of HAIs in Thailand were demonstrated. Notably, Acinetobacter spp. emerged as the most common etiologic agents of HAIs.

Lessons learned from influenza A(H1N1)pdm09 pandemic response in Thailand.

In 2009, Thailand experienced rapid spread of the pandemic influenza A(H1N1)pdm09 virus. The national response came under intense public scrutiny as the number of confirmed cases and associated deaths increased. Thus, during July-December 2009, the Ministry of Public Health and the World Health Organization jointly reviewed the response efforts. The review found that the actions taken were largely appropriate and proportionate to need. However, areas needing improvement were surveillance, laboratory capacity, hospital infection control and surge capacity, coordination and monitoring of guidelines for clinical management and nonpharmaceutical interventions, risk communications, and addressing vulnerabilities of non-Thai displaced and migrant populations. The experience in Thailand may be applicable to other countries and settings, and the lessons learned may help strengthen responses to other pandemics or comparable prolonged public health emergencies.

Strengthening emergency preparedness through the WHO emergency medical team mentorship and verification process: experience from Thailand.

The World Health Organization (WHO) emergency medical team (EMT) mentorship and verification process is an important mechanism for providing quality assurance for EMTs that are deployed internationally during medical emergencies. To be recommended for classification, an organization must demonstrate compliance with guiding principles and core standards for international EMTs and all technical standards for their declared type, in accordance with a set of globally agreed minimum standards. A rigorous peer review of a comprehensive documentary evidence package, combined with a 2-day verification site visit by WHO and independent experts, is conducted to assess an EMT's capacity. Key requirements include having sufficient systems, equipment and procedures in place to ensure an EMT can deploy rapidly, providing clinical care according to internationally accepted standards, being able to be fully self-sufficient for a period of 14 days and being able to fully integrate into the emergency response coordination structure and the health system of the country affected during deployment. Through the WHO mentorship programme, each EMT is provided with a mentor team, which guides and supports it during the preparatory process. The process typically takes around 1 to 2 years to complete. The Thailand EMT is the first team from the WHO South-East Asia Region to successfully complete the WHO mentorship and verification process. The experience of this process in Thailand can serve as an example for other countries in the South-East Asia Region and encourage them to strengthen their emergency preparedness and operational readiness by getting their national EMTs verified.

Seroprevalence of antibodies to avian influenza virus A (H5N1) among residents of villages with human cases, Thailand, 2005.

In 2005, we assessed the seroprevalence of neutralizing antibodies to avian influenza virus A (H5N1) among 901 residents of 4 villages in Thailand where at least 1 confirmed human case of influenza (H5N1) had occurred during 2004. Although 68.1% of survey participants (median age 40 years) were exposed to backyard poultry and 25.7% were exposed to sick or dead chickens, all participants were seronegative for influenza virus (H5N1).