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Purva M, Randeep G, Rajesh M, Mahesh CM, Sunil G, Subodh K, Sushma S, Naveet W, Pramod G, Arti K, Surbhi K, Omika K, Sonal K, Manoj S, Arunaloke C, Pallab R, Manisha B, Neelam T, Priscilla R, Subaramani K, Ebor J, Veeraraghavan B, Camilla R, Vijayalakshmi N, Vibhor T, Kuldeep S, Pradeep KB, Neeraj G, Daisy K, Vimala V, Chiranjay M, Vandana KE, Muralidhar V, Vijayshri D, Ruchita A, Kanne P, Sukanya S, Chand W, Neeraj G, Sanjay B, Sourav S, Karuna T, Saurabh S, Behera B, Sanjeev S, Thirunarayan MA, Reema N, Lahri S, Raja R, Hirak JR, Sujata B, Desma D, Mammen C, Sudipta M, Manas KR, Gaurav G, Swagata T, Satyajeet M, Anupam D, Tushar SM, Bashir AF, Gulnaz B, Shaista N, Sulochana D, Khuraijam RD, Langpoklakpam CS, Padma D, Anudita B, Ujjwala G, Neeta K, Geeta V, Tanvi S, Shristi J, Prachi V, Mamta L, Prithwis B, Anil CP, Clarissa L, Rajni G, Rushika S, Lata K, Vinod O, Kamini W. Assessment of core capacities for antimicrobial stewardship practices in indian hospitals: Report from a multicentric initiative of global health security agenda. Indian J Med Microbiol 2019; 37:309-317. [PMID: 32003327 DOI: 10.4103/ijmm.ijmm_19_445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Antimicrobial-resistant HAI (Healthcare associated infection) are a global challenge due to their impact on patient outcome. Implementation of antimicrobial stewardship programmes (AMSP) is needed at institutional and national levels. Assessment of core capacities for AMSP is an important starting point to initiate nationwide AMSP. We conducted an assessment of the core capacities for AMSP in a network of Indian hospitals, which are part of the Global Health Security Agenda-funded work on capacity building for AMR-HAIs. Subjects and Methods The Centers for Disease Control and Prevention's core assessment checklist was modified as per inputs received from the Indian network. The assessment tool was filled by twenty hospitals as a self-administered questionnaire. The results were entered into a database. The cumulative score for each question was generated as average percentage. The scores generated by the database were then used for analysis. Results and Conclusion The hospitals included a mix of public and private sector hospitals. The network average of positive responses for leadership support was 45%, for accountability; the score was 53% and for key support for AMSP, 58%. Policies to support optimal antibiotic use were present in 59% of respondents, policies for procurement were present in 79% and broad interventions to improve antibiotic use were scored as 33%. A score of 52% was generated for prescription-specific interventions to improve antibiotic use. Written policies for antibiotic use for hospitalised patients and outpatients were present on an average in 72% and 48% conditions, respectively. Presence of process measures and outcome measures was scored at 40% and 49%, respectively, and feedback and education got a score of 53% and 40%, respectively. Thus, Indian hospitals can start with low-hanging fruits such as developing prescription policies, restricting the usage of high antibiotics, enforcing education and ultimately providing the much-needed leadership support.
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Affiliation(s)
- Mathur Purva
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Guleria Randeep
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Malhotra Rajesh
- Department of Orthopedics, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - C Misra Mahesh
- Department of Surgery, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
| | - Gupta Sunil
- Department of Microbiology, Safdarjung Hospital and VMMC, Delhi, India
| | - Kumar Subodh
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Sagar Sushma
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Wig Naveet
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Garg Pramod
- Department of Gastroenterolog, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Kapil Arti
- Department of Microbiology, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Khurana Surbhi
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Katoch Omika
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Katyal Sonal
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Sahu Manoj
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Chakrabarti Arunaloke
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ray Pallab
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Biswal Manisha
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Taneja Neelam
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rupali Priscilla
- Department of Infectious Diseases, Christian Medical College and Hospital, Vellore, India
| | - K Subaramani
- Department of Surgery, Christian Medical College and Hospital, Vellore, India
| | - Jacob Ebor
- Department of Pediatrics, Christian Medical College and Hospital, Vellore, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
| | - Rodrigues Camilla
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Center, Mumbai, Maharashtra, India
| | - Nag Vijayalakshmi
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Tak Vibhor
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Singh Kuldeep
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - K Bhatia Pradeep
- Department of Anaesthesiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gupta Neeraj
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Khera Daisy
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Venkatesh Vimala
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | - K E Vandana
- Department of Microbiology, Kasturba Medical College, Manipal, Karnataka, India
| | - Varma Muralidhar
- Department of Medicine, Kasturba Medical College, Manipal, Karnataka, India
| | - Deotale Vijayshri
- Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Attal Ruchita
- Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Padmaja Kanne
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Sudhaharan Sukanya
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Wattal Chand
- Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, Kolkata, West Bengal, India
| | - Goel Neeraj
- Department of Microbiology, Sir Ganga Ram Hospital, Kolkata, West Bengal, India
| | - Bhattacharya Sanjay
- Department of Microbiology, Tata Medical Centre, Kolkata, West Bengal, India
| | - Sen Sourav
- Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
| | | | - Saigal Saurabh
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | - Singh Sanjeev
- Department of Infection Control, Amrita School of Medicine, Kochi, Kerala, India
| | - M A Thirunarayan
- Department of Microbiology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Nath Reema
- Department of Microbiology, Assam Medical College, Gwahati, Assam, India
| | - Saikia Lahri
- Department of Microbiology, Guahati Medical College, Gwahati, Assam, India
| | - Ray Raja
- Department of Microbiology, Institute of Post-Graduate Medical Education and Research, and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - J Raj Hirak
- Department of Microbiology, Institute of Post-Graduate Medical Education and Research, and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Baveja Sujata
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - D'Souza Desma
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Chandy Mammen
- Department of Haematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Mukherjee Sudipta
- Department of Critical Care Medicine, Tata Medical Center, Kolkata, West Bengal, India
| | - K Roy Manas
- Department of Surgical Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Goel Gaurav
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Tripathy Swagata
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Misra Satyajeet
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Dey Anupam
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - S Mishra Tushar
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - A Fomda Bashir
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Bashir Gulnaz
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nazir Shaista
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Devi Sulochana
- Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - R Devi Khuraijam
- Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - C Singh Langpoklakpam
- Department of Anaesthesiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Das Padma
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Bhargava Anudita
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Gaikwad Ujjwala
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Khandelwal Neeta
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Vaghela Geeta
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Sukharamwala Tanvi
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Jain Shristi
- Department of Critical Care and Respiratory Medicine, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
| | - Verma Prachi
- Department of Anaesthesiology and Critical Care, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
| | - Lamba Mamta
- Department of Microbiology, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
| | - Bhattacharyya Prithwis
- Department of Anaesthesiology and IC, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - C Phukan Anil
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Lyngdoh Clarissa
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Gaind Rajni
- Department of Microbiology, Safdarjung Hospital and VMMC, Delhi, India
| | - Saksena Rushika
- Department of Microbiology, Safdarjung Hospital and VMMC, Delhi, India
| | - Kapoor Lata
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Ohri Vinod
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Walia Kamini
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
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