Mortality Related to AMR in Patients With Hospital-acquired Infection
Mortality Related to AMR in Patients With Hospital-acquired Infection
This is a prospective surveillance study to estimate excess deaths due to and risk factors
 associated with antibiotic-resistant infection among patients with hospital-acquired
 infection (HAI) in a resource-limited setting. We will focus on six pathogenic bacteria that
 are of clinically important in the hospital.
We will first identify patients with pathogenic bacteria isolated from clinical sample
 collected >48 hours after admission. These patients will then be screened for eligibility
 criteria. Signed informed consent will be sought from the enrolled patients. The primary
 outcome is survival status within 28 days since the first specimen culture positive for one
 of the six organisms of interest. All patients with hospital-acquired infection will be
 assessed for in-hospital 28-day survival as part of the routine hospital surveillance system.
 Follow-up to confirm 28-day outcome via telephone call will be performed only if patient
 signed informed consent and permission is granted. All isolates from positive cultures will
 be collected and stored securely.

 This study will not interfere with standard patient care or routine diagnosis procedure,
 hence subject will receive no direct medical harm or benefits from being in the study.
 Researchers of this study will not be involved in the management, care and treatment of study
 subjects. Patient care will remain under the responsibility of the attending medical staff
 according to standard practice of care. The study team will work closely with the hospital
 Infectious Control team to screen and enroll patients as part of the HAI surveillance data
 system in Sunpasitthiprasong Hospital. This study will be an enhancement of the current HAI
 surveillance system, which will provide data on 28-day survival status, Charlson
 Comorbidities Index (CCI) score and Sequential Organ Failure Assessment (SOFA) score for each
 patient and risk factors related to acquiring hospital-acquired infection to the hospital
 Infectious Control (IC) team.
Inclusion Criteria:

 -  Male or female of any age admit at Sunpasitthiprasong Hospital

 -  At least one of the six organisms, which include Staphylococcus aureus, Enterococcus
 spp., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter
 spp., isolated from clinical specimen >48 hours after admission

 -  Acquired Bloodstream infection (BSI), Lower-respiratory tract infection(LRTI),
 Skin/Soft tissue infection (SSTI), Surgical-site infection (SSI), Urinary tract
 infection (UTI) or infection at other body sites >48 hours after admit at the hospital

 Exclusion Criteria:

 • Clinical symptoms of current infection presented ≤48 hours of admission