APSIC : Healthcare Associated

Infections (HAIs) surveilance in the

Asia Pacific Region

Ns.Wiwi Handayani,SKep.
 FAKTA: HAI Burden
Each year, 1 in 20 U.S. hospital patients
acquires a healthcare-associated infection.

$33 billion in potentially preventable health

care costs annually. 3
SOURCE: http://www.cdc.gov/HAI/burden.html 3
 Ancaman Kesehatan Global :

Antibiotic Resistance – The Silent

Tsunami
 1- MONGOLIA

2- NEPAL
3- CHINA

4- BANGLADESH

5- INDIA

6- THAILAND 8- PHILIPPINES

9- VIETNAM

7- SRI LANKA 10- MALAYSIA

11- SINGAPORE
SOUTH EAST ASIA
&
WESTERN PACIFIC
12- INDONESIA
13- PAPUA NEW GUINEA
13 COUNTRIES
 Fakta : Surveilans
• There are no standarts for HAIs diagnosis
• No intensive training programs / document on HAIs
surveillance
• % of hospitals performing HAIs surveillance is very low
• No national HAIs reporting system has been developed
• Severe antibiotic resistance
• Emerging, re-emerging diseases, multi antibiotic
resistant microorganisms occur in health care facilities
 APSIC : HAIs Surveillance
• CDC'S experience supporting HAI
surveillance in Asia, Paul Malpiedi : in
many low and middle income countries its
difficult to implement surveillance HAI
 APSIC : National surveillance of
HAI in Vietnam
• by Luong Ngoc Khue ( Director of Medical
Service Aministration Vietnam Ministry of
Health
• topic : Establishing Surveillance Sistem
Structure of IPC departemens of
hospitals in Vietnam
 Objectivitas AMR
1.Meningkatkan kesadaran masyarakat dan
tenaga kesehatan terhadap resistensi AB
2.Membangun jaringan pengawasan AMR
3.Memastikan pasokan obat-obat yang
berkualitas
4.Memperbaiki penggunaan obat yang
rasional
5.Mempromosikan IPC
6.Meningkatkan penggunaan antibiotik
rasional di bidang pertanian, peternakan
 APSIC : HAIs Surveillance
Epidemiology and control of HAIs with limited resources : finding of
international nosocomial infection control consortium ( INICC)
Dr.Victor Daniel Rosenthal :

 strategi multidimensi , Soft ware INICC Surveillance Online System

(ISOS),

 Melaporkan angka HAIs di 703 unit perawatan intensif (ICU) pada

50 negara : Amerika Latin, Eropa, Mediterania Timur, Asia
Tenggara, dan Pasifik Barat.
 Secara signifikan meningkatkan Compliance Hand Hygiene dan
bundle di 19 negara : Argentina, Brazil, China, Colombia,Costa
Rica,Cuba,ElSavador,Greece,India,Kuwait,Lebanon,Lithuania,
Macedonia,Malaysia,
Mexico,Morocco,Pakistan,Panama,Peru,Philippnes,Poland,Saudi
Arabia,Tuni dan Turkey
 Manfaat surveilans bagi RS
• Perbaiki metode untuk mengumpulkan
data tentang HAI
• Membuat kebijakan dan prosedur untuk
mengurangi HAIs
• Mendukung penggunaan obat antimikroba
yang tepat
Six INICC international reports
(one every second year, from 2006 to 2016)

Publication 2006 2008 2010 2012 2014 2016

year

Number of 8 18 25 36 43 50
Countries

Peer Review Annals of Internal American American American American American

Journal Medicine Journal of Journal of Journal of Journal of Journal of
Infection Infection Infection Infection Infection
Control Control Control Control Control

21
Six (6) INICC international reports,
published from 2006 to 2016

INICC 2002- INICC 2002- INICC 2003- INICC 2004- INICC 2007- INICC 2010-
2005 2007 2008 2009 2012 2015
(Published in (Published in (Published in (Published in (Published in (Published in
2006) 2008) 2010) 2012) 2014) 2016)
Pooled Mean Pooled Mean Pooled Mean Pooled Mean Pooled Mean Pooled Mean

Countries, n 8 18 25 36 43 50

ICUs, n 55 98 173 422 503 703

CLABSI, 12.5 9.2 7.6 6.8 4.8 4.1

rate (per 1000
CL- days)

CAUTI, rate 8.9 6.5 6.3 6.3 5.3 4.82

(per 1000 UC
days)

VAP, 24.1 19.5 13.6 15.8 14.7 12.2

Rate (per 1000
MV days)
4/4/2019 22
Trends in central line-associated blood stream
infections (CLABSI) in hospitals, 2006 – 2014

Source: CDC’s National Healthcare Safety Network (NHSN)

3 CLABSI data reflect progress in acute-care hospitals only.
Trends in catheter-associated urinary tract infections
(CAUTI) in hospitals 2009 – 2014

Source: CDC’s National Healthcare Safety Network (NHSN)

Trends in surgical site infections
(SSI) in hospitals, 2006 – 2014

Source: CDC’s National Healthcare Safety Network (NHSN)

 Trends in catheter-associated urinary tract infections
(CAUTI) in hospitals, 2009 – 2014

Source: CDC’s National Healthcare Safety Network (NHSN)

4 CAUTI data reflect progress in acute-care hospitals only. Although 2009 –
2014 data show no change in overall CAUTI SIRs, specific hospital units
showed major changes in CAUTI SIRs: 24% decrease in hospital wards and
16% increase in hospital intensive care units (ICUs).
 Trends in healthcare-associated invasive methilicillin-
resistant Staphylococcus aureus (MRSA) infections, 2007 –
2014

Source: Emerging Infections Program / Active Bacterial Core Surveillance

5 Starting in 2015, the MRSA data source will be Emerging Infections Program
/ Healthcare-Associated Infections Component (EIP / HAIC) and National
Healthcare Safety Network (NHSN).
 Kesimpulan
• Surveilans bertujuan untuk mengukur dan
menurunkan : rate HAIs, mortality, cost
• Meningkatkan compliance bundles care
• Evaluasi kebijakan dan prosedur
Thank you for your attention!