Some hospitalized patients have community-acquired AMR infections and some have hospital-acquired infections. Hospital-acquired infection, infection that occurred after hospitalization for at least 48 hours, is common and most of these infections are caused by AMR bacteria, including ESBL-producing Enterobacteriaceae, carbapenem-resistant P.aeruginosa and A.baumannii, and MRSA. AMR in hospital is usually associated with inappropriate use of antimicrobials and inefficient infection prevention and control practices. Inappropriate use of antimicrobials for surgical prophylaxis and therapy of suspected or documented infections in hospitalized patients is very prevalent, from 25% to 92%. Many hospital-acquired infections caused by AMR bacteria can be prevented by infection prevention and control practices, especially hand hygiene, barrier precautions and environmental decontamination. However, the compliance with a single most effective and basic infection prevention and control measure, hand hygiene, of many healthcare personnel in many Thai hospitals is still inadequate.
The aforementioned dynamics of AMR chains in community and in hospital are used to design the campaigns of AMR containment program by interrupting the dynamics of AMR chains as shown in Figure 2.3. and Figure 2.4. STOP producing AMR is promoting responsible use of antibiotics, whereas STOP acquiring AMR and STOP transmitting AMR are promoting good sanitation and hygiene, and compliance to infection prevention and control practices.
Figure 2.3. AMR containment and prevention campaign in community
Figure 2.4. AMR containment and prevention campaign in hospital