A Prospective Quasi-Experimental Study of Multifaceted Interventions Including Computerized Drug Utilization Evaluation to Improve an Antibiotic Stewardship Program.

Objective: This study aimed to determine and evaluate interventions that improve an antibiotic stewardship program (ASP) in reduction of the amount of antibiotic use and errors in drug utilization evaluation (DUE) form completion.

Methods: A prospective quasi-experimental study was conducted to evaluate the effectiveness of the multifaceted interventions (preauthorization with computerized DUE, self-supervised checklists, and short active reminders of the antibiotic guidelines recommendations) incorporating an ASP among hospitalized internal medicine patients in a Thai tertiary care center. The preintervention period was from January to December 2018, and the postintervention period was from February 2019 to January 2020.

Risk categorization and outcomes among healthcare workers exposed to COVID-19: A cohort study from a Thai tertiary-care center.

Background: A risk categorization tool for healthcare workers (HCWs) exposed to COVID-19 is crucial for preventing COVID-19 transmission and requires validation and modification according to local context.

Methods: From January to December 2021, a prospective cohort study was conducted among Thai HCWs to evaluate the performance of the specifically-created risk categorization tool, which classified HCWs into low-risk (LR), intermediate-risk (IR), and high-risk (HR) groups based on types of activities, duration of exposure, and protective methods used during exposure. Subsequent measures were determined for the HCWs based on the risk categories.

Postflood pseudofungemia due to Penicillium species.

We report an outbreak investigation of fungemia due to Penicillium species after prolonged flooding of a Thai hospital. Contaminated rubber diaphragms of blood culture bottles were identified, and the pseudo-outbreak was resolved after environmental cleaning, use of high-efficiency particulate air filtration, and strict compliance with basic infection control practices for blood culture procurement.

Effectiveness of a catheter-associated bloodstream infection bundle in a Thai tertiary care center: a 3-year study.

Background: We sought to determine the long-term impact of "bundled" infection control interventions on the rates of catheter-associated bloodstream infection (CA-BSI) in a middle-income country.

Setting: A 500-bed tertiary care center in Thailand.

Methods: A 3-year, hospital-wide, prospective quasi-experimental study was conducted for 1 year before the intervention (period 1), 1 year after implementation of the CA-BSI bundle (period 2), and at a 1-year follow-up after the intervention with intensified hand hygiene promotion (period 3).

Tuberculin skin tests among medical students with prior bacille-Calmette Guérin vaccination in a setting with a high prevalence of tuberculosis.

Presence of a bacille Calmette-Guérin vaccination scar in medical students was an independent factor associated with initial tuberculin skin test reactions of 10-19 mm (P=.03) and booster effects of 6-9 mm (P=.02).

Evidence of vaccine protection among thai medical students and implications for occupational health.

In a cross-sectional study of Thai medical students, we compared the seroprevalence of antibody to measles virus, rubella virus, varicella zoster virus, hepatitis A virus, and hepatitis B virus with self-reports of prior infection or vaccination. Self-report predicted immunity to varicella zoster virus only. These data contribute to risk assessment and occupational health strategies in this resource-limited setting.

A multifaceted intervention to reduce pandrug-resistant Acinetobacter baumannii colonization and infection in 3 intensive care units in a Thai tertiary care center: a 3-year study.

Background: We sought to determine the long-term effect of a multifaceted infection-control intervention to reduce the incidence of pandrug-resistant Acinetobacter baumannii infection in a Thai tertiary care center.

Methods: A 3-year, prospective, controlled, quasi-experimental study was conducted in medical intensive care, surgical intensive care, and coronary care units for a 1-year period before intervention (period 1), a 1-year period after intervention (period 2), and a 1-year follow-up period (period 3). The interventions in period 2 included strictly implementing contact isolation precautions and appropriate hand hygiene, active surveillance, cohorting patients who were colonized or infected with pandrug-resistant A.

Outbreak of postoperative endophthalmitis in a Thai tertiary care center.

We performed a study with a 1:3 ratio of case patients (n = 11) to control patients (n = 33) to evaluate risk factors for postoperative endophthalmitis in a Thai tertiary care center. Multivariate analysis revealed that diabetes mellitus and surgeon A were associated risk factors. Preoperative diabetes mellitus control and the improvement of infection control practices led to the termination of the outbreak.

Initial inappropriate urinary catheters use in a tertiary-care center: incidence, risk factors, and outcomes.

Objectives: To evaluate the epidemiology and outcomes for initiation of inappropriate urinary catheterization (IUC) among hospitalized patients.

Setting: A 450-bed, tertiary-care hospital.

Patients: All patients admitted to the hospital from September 1, 2003 to June 12, 2004 with urinary catheter (UC).

Effectiveness of an educational program to reduce ventilator-associated pneumonia in a tertiary care center in Thailand: a 4-year study.

Background: Ventilator-associated pneumonia (VAP) is considered to be an important cause of infection-related death and morbidity in intensive care units (ICUs). We sought to determine the long-term effect of an educational program to prevent VAP in a medical ICU (MICU).

Methods: A 4-year controlled, prospective, quasi-experimental study was conducted in an MICU, surgical ICU (SICU), and coronary care unit (CCU) for 1 year before the intervention (period 1), 1 year after the intervention (period 2), and 2 follow-up years (period 3).

Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand.

Objective: To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters.

Methods: A hospitalwide preintervention-postintervention study was conducted over 2 years (July 1, 2004, through June 30, 2006). The intervention consisted of nurse-generated daily reminders that were used by an intervention team to remind physicians to remove unnecessary urinary catheters, beginning 3 days after insertion.

Pseudo-outbreak of Acinetobacter lwoffii infection in a tertiary care center in Thailand.

We describe a pseudo-outbreak of Acinetobacter lwoffii infection that was recognized early. The pseudo-outbreak involved 16 patients and occurred 3.5 months after the GNS-506 Vitek automated system was introduced in the microbiology laboratory.

Outbreak of varicella-zoster virus infection among Thai healthcare workers.

Objective: To evaluate the correlation between self-report of a prior history of chickenpox and results of varicella-zoster virus (VZV) immunoglobulin (Ig) G serologic test results in an outbreak of VZV infection among Thai healthcare workers (HCWs) and to conduct a cost-benefit analysis of establishing routine VZV immunization as part of an occupational health program on the basis of the outbreak data.

Methods: All exposed patients received prophylaxis and the HCWs in our 3 intensive care units (ICUs) were prospectively evaluated. HCWs were assessed for disease history and serologic evidence of VZV IgG.

Atypical avian influenza (H5N1).

We report the first case of avian influenza in a patient with fever and diarrhea but no respiratory symptoms. Avian influenza should be included in the differential diagnosis for patients with predominantly gastrointestinal symptoms, particularly if they have a history of exposure to poultry.