Search PubMed⌕ Search

Biomedical subjects

S Danchaivijitr

Publications and source records attributed to S Danchaivijitr.

At least 19 recordsLinked to original sources
PubMed2001

First report of methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Thailand.

To investigate whether there are methicillin-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin in Thailand, a total of 155 MRSA strains isolated from patients hospitalized between 1988 and 1999 in university hospitals in Thailand were tested for glycopeptide susceptibility. All the strains were classified as susceptible to vancomycin and teicoplanin when judged by NCCLS criteria for glycopeptide susceptibility using the agar dilution MIC determination. Vancomycin MICs at which 50 and 90% of the isolates tested were inhibited (MIC50 and MIC(90), respectively) were 0.5 and 1 microg/ml, respectively, with a range of 0.25 to 2 microg/ml. For teicoplanin, MIC50 and MIC90 were 2 microg/ml, with a range of 0.5 to 4 microg/ml. However, one-point population analysis identified three MRSA strains, MR135, MR187, and MR209, which contained subpopulations of cells that could grow in 4 microg of vancomycin per ml. The proportions of the subpopulations were 2 x 10(-4), 1.5 x 10(-6), and 4 x 10(-7), respectively. The subsequent performance of a complete population analysis and testing for the emergence of mutants with reduced susceptibility to vancomycin (MIC > or = 8 microg/ml) confirmed that these strains were heterogeneously resistant to vancomycin. Two of these strains caused infection that was refractory to vancomycin therapy. Pulsed-field gel electrophoresis showed that the two strains had identical SmaI macrorestriction patterns and that they were one of the common types of MRSA isolated in the hospital. This is the first report of heterogeneous resistance to vancomycin in Thailand and an early warning for the possible emergence of vancomycin resistance in S. aureus in Southeast Asia.

Adolescent↗
PubMed2001

Bacterial infections in hospitalized patients in Thailand in 1997 and 2000.

Two surveys to determine the patterns of bacterial infections and trends in resistance to antibiotics of bacteria causing infections in patients admitted to hospitals in Thailand were conducted in 36 and 37 hospitals throughout Thailand in June 1997 and February 2000. Approximately 50 per cent of infections in hospitalized patients in Thailand were hospital-acquired infections. Urinary tract and lower respiratory tract were the most common sites of infections. Eighty per cent of infections were caused by gram negative bacteria. Gram negative bacteria causing infections in 2000 were more resistant to most commonly used antibiotics when compared with those in 1997. The prevalence of gram positive bacteria causing hospital-acquired infections significantly increased during this period. The trend of increase in resistance in most gram positive bacteria in 2000 was not clearly observed.

Anti-Bacterial Agents↗
PubMed2001

Microbial killing activity of peracetic acid.

In vitro killing activity of peracetic acid (Perasafe) at a concentration of 0.26 per cent w/v was tested against Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Salmonella paratyphi A, Acinetobacter baumannii, Sternotrophomonas maltophilia, Enterococcus faecium, Enterococcus faecalis, methicillin-resistant Staphylococcus aureus (MRSA), Bacillus subtilis spore, Mycobacterium tuberculosis and human immuno-deficiency virus type I. Exposure to Peracetic acid (0.26% w/v) for 10 minutes resulted in massive killing of all the aforementioned organisms and spore.

Bacteria↗
PubMed1998

Impact of an educational program on antibiotic use in a tertiary care hospital in a developing country.

A multi-cross-sectional study was conducted in a 2000-bed tertiary care university hospital in Bangkok, Thailand, from September 1993 to May 1994 to assess the effectiveness of an educational program on the use of antibiotics. Data on the study covered antibiotic usage both in-patients and out-patients. Data were collected for a 24-hour period every 2 weeks for 7 days for each 3-month period. The target population were residents, general practitioners, and sixth-year medical students. The educational program provided information derived from the data of inappropriate use of antibiotics during the pre-intervention period and guidelines on the use of antibiotics which were agreed to by a consensus among the faculty in all clinical departments. The study revealed: (1) the prevalence of antibiotic use and the cost of antibiotics during post-intervention period was significantly decreased by 20%; (2) the use of antibiotic prophylaxis for obstetrics patients and patients undergoing cataract surgery decreased significantly; (3) there was a shift from second or third generation cephalosporins to cefazolin for surgical prophylaxis; (4) the duration of perioperative antibiotic prophylaxis was reduced to under 2 days; (5) there was a shift from netilmicin or amikacin to gentamicin for the treatment of community acquired infection; and (6) the mortality, median length of hospital stay, and nosocomial infection rate among the patients who received antibiotics during the post-intervention period were not significantly different from those during the pre-intervention period. These results suggest that this educational program comprising information feedback and antibiotic usage guidelines was effective in improving antibiotic use at this tertiary care university hospital in Thailand.

Anti-Bacterial Agents↗
PubMed1997

Universal precautions: costs for protective equipment.

BACKGROUND: The amount and costs of protective equipment used to implement universal precautions in Thailand have not previously been studied. METHODS: A cross-sectional study was done to determine the frequency of clinical and laboratory procedures requiring universal precautions and the amount of protective equipment needed for each. RESULTS: The study was performed in 24 government hospitals in Thailand in December 1993. Totaling 6549 beds, these hospitals had provided service to 357,391 inpatients and 3,411,122 outpatients during the previous year. The annual number of procedures performed in these hospitals was estimated at 17.5 million, with expenditures for protective equipment of $2.4 million (U.S.) per year. The average overall cost for protective equipment was U.S. $5.37 for one inpatient stay and U.S. $0.15 for one outpatient visit. The projected national expense for these barriers was U.S. $41.5 million per annum. The cost for these barriers after the implementation of universal precautions was 2.5 times the cost before implementation. CONCLUSIONS: Overuse of sterile and examination gloves and gowns and underuse of heavy-duty gloves, masks, aprons, goggles, and boots were discovered during the study. Appropriate use of disposable and reusable universal precautions equipment would free health care dollars for other purposes.

Costs and Cost Analysis↗
PubMed1996

Efficacy of hospital infection control in Thailand 1988-1992.

Hospital infection control in Thailand was initiated in 1971, but it was not until 1987 that active infection control activities actually started. To evaluate the efficacy of the infection control programme, two national prevalence studies of hospital acquired infection (HAI) were undertaken. The HAI prevalence rate in 1988 was 11.7%; this was reduced to 7.3% four years later. The reduction of HAI was found in hospitals of all sizes, in all types of infection and almost all services. This reduction happened despite a shortage of infection control personnel. Co-operation of administrators, doctors and nurses is essential for success in HAI control. Such co-operation has been successfully created by the Nosocomial Infection Control Group of Thailand.

Adolescent↗
PubMed1995

Contamination of mercurochrome and chlorhexidine-cetrimide in a teaching hospital.

A study on the contamination of antiseptics was done in a teaching hospital, during March and April 1989. Ninety-five samples of 9 antiseptics from 23 wards were cultured. Results showed that 2 of 12 and 3 of 5 samples of mercurochrome and chlorhexidine-cetrimide compound were contaminated. This led to a wider scale study on the two products. It was found that over one-half of the samples of mercurochrome and 6 of 54 samples of chlorhexidine-etrimide compound were contaminated. Mercurochrome was contaminated by gram-positive and chlorhexidine-cetrimide compound by gram-negative bacteria. Contamination of mercurochrome was found in samples taken from the pharmacy and wards, and of chlorhexidine-cetrimide compound from wards only. Mercurochrome was removed from the hospital formulary and the use of chlorhexidine-cetrimide compound was more restricted.

Anti-Infective Agents, Local↗
PubMed1995

Needlesticks and cuts with sharp objects in Siriraj Hospital 1992.

A study on needlesticks and cuts with sharp objects was done by a set of questionnaires in Siriraj Hospital in March 1992. The response rate of 3,600 sets of questionnaires was 80.8%. The recalled incidence rate of injuries in the previous 6 months was 51.5%. Needlesticks were the commonest accident followed by cuts by broken glass and medical equipment respectively. Bore needles were the most important cause of injury. Recapping and improper disposal of used needles were prevalent. With the same incidence rate of such injuries, it was estimated that 5.9 persons will be HIV infected annually in Thailand.

Accidents, Occupational↗
PubMed1995

Universal precautions: knowledge, compliance and attitudes of doctors and nurses in Thailand.

A study on the knowledge, compliance and attitudes of doctors and nurses on "universal precautions" (U.P.) was done by questionnaire in April 1993. Four hundred and sixty-nine doctors and 4,554 nurses from 35 hospitals throughout Thailand responded. Almost all doctors and nurses understood the definition of U.P.. The latter were correctly applied in less than half of the personnel. A significant number of doctors and nurses required HIV screening tests and isolation of patients with HIV infections. Most doctors and nurses knew that sharp injuries were the most important cause of acquiring HIV infection in health-care settings. Those who are more vulnerable to injury would take more precautions. Up to a quarter of doctors and nurses did not fully understand how to use protective barriers properly. The practice of handwashing needs to be improved. Both doctors and nurses were willing to take care of HIV infected patients. They supported the application of U.P. as a safety measure. Welfare support for health-care workers who have contacted HIV at work is also expected.

Adult↗
PubMed1995

The Second Thai National Prevalence Study on Nosocomial Infections 1992.

A prevalence study on N.I. in Thailand was repeated in 1992 to evaluate the efficacy of the ongoing control programme. The survey included 10,373 patients in 33 hospitals throughout Thailand. The prevalence rate of N.I. in this study was 7.3 per cent. When compared with a previous study done in 1988, it was found that the prevalence rate had decreased by 4.4 per cent. The reduction of N.I. occurred in all types of hospitals, and in all services. Major reduction was found in the age groups 5-14, 15-24 and 25-34 years, in orthopaedics, paediatrics and surgical departments. Lower respiratory tract infections were the commonest infection in this study while urinary tract infection was the commonest in 1988. Overuse of antimicrobials was discovered in this survey. The success in reduction of N.I. was attributed to the increase in N.I. activities. Campaigns against N.I. since 1988 seem effective and should be intensified.

Adolescent↗
PubMed1995

A national study on surgical wound infections 1992.

A study on SWI was done in 33 hospitals in Thailand between March 16 and May 15, 1992 involving 15,319 surgical wounds. The average incidence rate of SWI as 2.7 per cent. It was highest in provincial hospitals. Patients aged under 10 years and 51-60 years had higher rates of SWI. It was most prevalent in the surgical department followed in rank by accident and orthopaedic departments respectively. Wound types were the most important denominator of SWI; the incidence of SWI in dirty, contaminated, clean-contaminated and clean wounds were 9.7, 5.1, 1.5 and 1.3 per cent respectively. Antimicrobial prophylaxis were used in 76.7 per cent of the wounds. Ampicillin, gentamicin and cloxacillin were the commonly used drugs. Prevention of SWI needs to be improved in provincial hospitals and in the use of prophylactic antimicrobials.

Adolescent↗
PubMed1995

Infusion-related phlebitis.

The incidence rate and risk factors of infusion-related phlebitis was studied in 1993. Thirty-five hospitals were enrolled. Data were collected from 6,256 infusion sites. Male and female patients were almost equal. Forearms were the commonest site of infusion, followed by hand and arm respectively. In 34.1 per cent the infusion was interrupted by complications of which 6.2 per cent was phlebitis. It was mild in most cases. Increased incidence rates of infusion related phlebitis were associated with: the use of plastic cannulas, dextrose containing solutions, administration at the sites other than hand and concomitant administration of antimicrobials. The incidence rate of phlebitis rose sharply after 24 hours of infusion. It is concluded that in addition to proper insertion and good nursing care, the avoidance of the above risk factors will lead to a lower incidence of infusion-associated phlebitis.

Adolescent↗
PubMed1995

Infusion phlebitis in medical and surgical patients in Siriraj Hospital.

A study on infusion phlebitis was done in medical and surgical departments in Siriraj Hospitals from February to April 1992. Two hundred and eighty-one patients and 406 infusion sites were included. The infusion time was 40.6 +/- 31.9 hours. The incidence rate of phlebitis was 25.9%. There was no difference in its occurrence in medical and surgical patients. Dorsum of the hand was the site associated with low incidence and less severe phlebitis. The contrary applied to the forearm and arm. Plastic cannulae were associated with higher incidence, more severe phlebitis than steel needles, but this was not statistically significant. Intravenous antimicrobials were followed by higher incidence and more severe phlebitis. The value of early diagnosis of infusion phlebitis so as to halt its progress was also demonstrated in the study. In no case was the phlebitis, in the most severe form i.e. grade 5, encountered.

Adolescent↗
PubMed1995

An outbreak of Norwegian scabies in a surgical ward.

An outbreak of Norwegian scabies in a surgical ward of a teaching hospital was reported. The source of infestation was an elderly diabetic. The epidemic involved 28 of 32 medical personnel in the ward and 3 family contacts. All infected individuals were given a two-course treatment with hexachlorcyclohexane gel. Control of the outbreak was achieved by strict handwashing after patient contact, application of gowns and gloves for contact with skin lesions and the treatment of infected persons. Norwegian scabies in institutions is on the rise, vigilance for its occurrence is needed.

Cross Infection↗
PubMed1995

Effects of education on the prevention of pressure sores.

A controlled study was done to evaluate the efficacy of written guidelines on the prevention of pressure sores. Thirty-three hospitals in Thailand were enrolled from February to April 1991. The incidence of pressure sores in the 6 week control period was 8.7 per cent compared to 6.5 per cent in the study phase. Reduction of the complication was found in all medical, surgical and intensive care departments. Practices on the prevention of pressure sores by nurses were significantly improved regarding: positioning, seating, not pulling, and bed-bathing of patients. Massaging the immobilized parts and the application of supporting devices were not increased by the education programme. This method of education is simple and appropriate for hospitals in Thailand.

Adolescent↗
PubMed1995

Use of antiseptics and disinfectants in Thailand 1990.

A survey by questionnaire was done in March and April 1990 on the use of antiseptics and disinfectants (A/D). Twenty-seven hospitals with 675 wards were enrolled. Results showed that the cost of A/D was 3.3 to 8.1 per cent of the total expenses for drugs. Essential A/D were available and used in most places. Many low level A/D, which have been excluded from modern hospitals, were still employed. Contamination of A/D was a real threat due to improper preparation, unclean containers and refill practices in many wards. Improper applications of A/D, namely: overuse, underuse, and wrong choices were found in many places. Textbooks and written guidelines were available but it is unlikely that they were referred to in practice. A national policy on the use of A/D and proper education to medical personnel are clearly needed.

Anti-Infective Agents, Local↗
PubMed1995

Basic elements for the control of nosocomial infection in Thai hospitals.

A survey on the basic elements for the control of N.I. was done in 38 hospitals in Thailand in 1991. Manpower shortage was found in one half of them. Service by the microbiological laboratory was under-utilized. Good guidelines on N.I. control needed to be more widely adopted. Capacity of C.S.S.D. lagged behind demands in most hospitals. Water supply was of most concern and needed to be improved in all. Waste-water treatment plants were needed in about one half of the hospitals. Personnel working in catering did not receive adequate screening for communicable diseases in one-half. Workers in the laundry department needed education on infection prevention in about one-third of hospitals. Improper disposal of infectious waste was found in one-quarter. The results of the study indicated that a comprehensive programme is needed for improving the efficacy of N.I. control in Thailand.

Cross Infection↗