VietNamNet Bridge – The death of four pre-term and low birth weight infants at a hospital in the northern province of Bac Ninh in Monday, which was said to have been caused by hospital-acquired infections, has raised the alarm about this issue in Vietnam.

Newborn care at Bac Ninh Hospital of Obstetrics and Pediatrics. — Photo thanhnien.vn

The newborns were admitted to the Bac Ninh Hospital of Obstetrics and Pediatrics between November 12 and 16 to receive neonatal intensive care following their premature arrivals. They were born between the 32nd and 35th week of pregnancy, and all weighed less than 2.3 kilograms.

Sadly, one by one, they were all pronounced dead between 2:00am and 9:30am on Monday morning, while receiving neonatal treatment at the hospital.

Officials said they died of respiratory failure, septic shock and multiple organ failure.

A working group was set up a day later to investigate the exact causes behind the deaths, and concluded that the preemies died of hospital-acquired infections.

After the incident, Minister of Health Nguyen Thi Kim Tien ordered the immediate transfer of other critically-ill infants receiving treatment at Bac Ninh Hospital to centrally-administered ones.

Tien said apart from hospital-acquired infections, overloading at the Bac Ninh Hospital was another cause for concern.

There are 320 beds for children at the hospital, of which 90 are for infants. Of these 90 infant beds, 25 beds are for the critically ill. Meanwhile, the department for infants only had seven doctors and 25 nurses, which, in theory, could only work on the 25 beds for the critically ill, the minister said.

“But of course this is an unusual case,” she said.

Of the three infants transferred from Bac Ninh Hospital to Bach Mai Hospital in Hanoi, one had severe septicemia and is still in critical condition. Seven other infants from Bac Ninh Hospital were also transferred to the National Paediatrics Hospital and National Hospital of Obstetrics and Gynecology on Tuesday.

Not just a single case

Doctors have long warned about hospital-acquired infections (HAIs) in Vietnam, before this tragedy happened.

Statistics from the health ministry said that on average the rate of HAIs in Vietnam is 7 per cent and one of the leading threats to patients’ lives.

Deputy Minister Nguyen Viet Tien once said that HAIs had a large impact on patients’ treatment process. Many cases were hospitalised when their conditions were not critical, but worsened due to hospital’s infection control.

Nguyen Viet Hung, head of the Infection Control Department at Bach Mai Hospital in Hanoi, said the rate of HAIs in Bach Mai Hospital has reduced by almost 50 per cent in the last 10 years, but was still high compared to other countries in the region – ranging between 15 and 20 per cent.

A study titled “Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units” by doctor Vu Dinh Phu from the National Hospital of Tropical Diseases and colleagues in 2016, revealed that the HAI prevalence in 15 Intensive Care Units of hospitals in the country ranged from 19.3 per cent to 31.1 per cent.

The study, which was carried out from 2012-13 on hospital sizes ranging from 280 to 2,362 beds, with participating ICU sizes ranging from 10 to 60 beds, found that 29.5 per cent of patients staying in ICUs had at least one HAI; 922 patients had one HAI, 39 patients had two HAIs, and four patients had three HAIs.

Most HAIs, 84 per cent, were acquired in the survey hospitals: 42.5 per cent acquired prior to ICU admission and 57.5 per cent developed after ICU admission.

Ta Thi Hang Nga, head of the Infection Control Department of Dong Da Hospital, said that the hospital environment, medical materials and health staff might all be threats of infection.

“Infections from the hands of health staff are mostly threatening if they do not properly wash their hands,” Nga said.

She also said overloading is a reason for this negligence.

Nguyen Dinh Hung, director of Saint Paul Hospital in Hanoi, said proper use of alcohol rub can reduce the risk of infection by between 10 and 45 per cent.

The study by Vu Dinh Phu suggested the same thing, when saying that low healthcare staff ratios and high bed occupancy rates made infection control very challenging.

“The lack of nursing staff for patient care allows little time for proper infection control measures, which may lead to an increased HAI rate. This is supported by the smaller amount of alcohol hand rub used: a median of 66.4 ml/patient per day, compared with a median of 83 ml/patient per day in ICUs of Germany in 2010,” the study said.

Nguyen Viet Hung from Bach Mai Hospital said patients’ families are advised to strictly follow hygiene rules in hospitals, Hung said, and emphasised that improved infection control in hospitals, including upgrades to facilities, wastewater treatment systems and regular inspections of infection control practices, will help reduce the risk of hospital-acquired infections. 

Source: VNS