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Epidemiology and burden of multidrug-resistant bacterial infection in a developing country

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Cite this article as: eLife 2016;5:e18082 doi: 10.7554/eLife.18082

Abstract

Little is known about the excess mortality caused by multidrug-resistant (MDR) bacterial infection in low- and middle-income countries (LMICs). We retrospectively obtained microbiology laboratory and hospital databases of nine public hospitals in northeast Thailand from 2004 to 2010, and linked these with the national death registry to obtain the 30-day mortality outcome. The 30-day mortality in those with MDR community-acquired bacteraemia, healthcare-associated bacteraemia, and hospital-acquired bacteraemia were 35% (549/1,555), 49% (247/500), and 53% (640/1,198), respectively. We estimate that 19,122 of 45,209 (43%) deaths in patients with hospital-acquired infection due to MDR bacteria in Thailand in 2010 represented excess mortality caused by MDR. We demonstrate that national statistics on epidemiology and burden of MDR in LMICs could be improved by integrating information from readily available databases. The prevalence and mortality attributable to MDR in Thailand are high. This is likely to reflect the situation in other LMICs.

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Author details

  1. Cherry Lim

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-2555-6980
  2. Emi Takahashi

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  3. Maliwan Hongsuwan

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  4. Vanaporn Wuthiekanun

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  5. Visanu Thamlikitkul

    Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  6. Soawapak Hinjoy

    Bureau of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  7. Nicholas PJ Day

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  8. Sharon J Peacock

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  9. Direk Limmathurotsakul

    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
    For correspondence
    direk@tropmedres.ac
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7240-5320

Funding

Ministry of Public Health

  • Direk Limmathurotsakul

Wellcome (100484/Z/12/Z)

  • Nicholas PJ Day
  • Direk Limmathurotsakul

Wellcome (100484/Z/12/Z)

  • Cherry Lim

Wellcome (101103/Z/13/Z)

  • Direk Limmathurotsakul

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Quarraisha Abdool Karim, University of KwaZulu Natal, South Africa

Publication history

  1. Received: May 23, 2016
  2. Accepted: August 24, 2016
  3. Accepted Manuscript published: September 6, 2016 (version 1)
  4. Version of Record published: September 20, 2016 (version 2)

Copyright

© 2016, Lim et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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