Assessment of Antimicrobial Stewardship and Infection Control Indicators in Regional Acute-Care Hospitals in Latvia – Interdisciplinary Mixed Methods’ Research

Description

Antimicrobial stewardship (AMS) and Infection prevention and control (IPC) are the key elements in limiting the emerging antimicrobial resistance (AMR). AMS is included in Latvia's National One Health action plan, but there is no data on the actual prevalence of AMS program components, epidemiological indicators and barriers for the implementation in regional hospitals (RH) in Latvia. This study aimed to assess ongoing AMS and IPC activities in acute care RH in Latvia and integrate epidemiological and behavioral science data to identify site-specific barriers and develop context-specific recommendations. Mixed-method research was applied in eight RH in Latvia between 2019 and 2021, including evaluation of AMS program components, antimicrobial consumption data, epidemiological data, audits of infection prevention and control, and qualitative study of contextual factors. To encourage continuous AMR and IPC data analysis at the study sites, the train-the-trainer principle was applied.. The study revealed high antibiotic consumption in RH in 2019 (66.6 DDD/100 bed-days) which has further increased in 2020 (73.1 DDD/100 BD). This trend was also reflected in the Point Prevalence Survey data, where we observed that 48.4% (654/1350) of included patients receive antibiotics. 51.8% of prescribed AB were third-generation cephalosporins. We also observed marked heterogeneity in the choice of antibiotics (e.g. 23 different antibiotics were prescribed for community-acquired pneumonia, 15 - for lower urinary tract infection). 81% (92/114) of patients were prescribed a prolonged perioperative antibiotic prophylaxis. Median blood culture sampling practices were low at only 6.2 sets/1000BD. The qualitative interviews have indicated the lack of national antibiotic guidelines, financial support and qualified and dedicated staff to implement the AMS programme.. The study has identified significant gaps in AMS and IPC programs in RH in Latvia, highlighting heterogeneity between study sites and be applied to inform further strengthening of AMS components in RH.

Period	29 Mar 2023
Event title	RSU Research week 2023: Society. Health. Welfare
Event type	Conference
Conference number	9
Organiser	Rīga Stradiņš University
Location	Riga, LatviaShow on map
Degree of Recognition	International