Vietnam lagging behind in bacterial fight

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Children and their families occupy corridors at Ho Chi Minh City Children's Hospital No.1, one of the two major pediatrics facilities in the city

Recently, a 52-year-old man from Ho Chi Minh City, identified by his initials as L.V.N., received endoscopic surgery to have his kidney stones removed, but the small cut did not heal after more than two weeks and it began to leak pus.

The cut was later found to have been infected with bacteria.

Doctors were cited in a Nguoi Lao Dong report last month as saying it was a rare case as endoscopic surgery is known for minimizing such problems associated with traditional invasive surgery.

They also said the case was an example showing microorganisms are evolving out of control.

Pham Duc Muc, deputy head of the Examination and Treatment Management Department at the Health Ministry, said there are four sources of bacterial infection at hospitals, and one of them is superbugs that are highly immune to antibiotics because of improper use and overuse.

Other sources are the environment including water, air, foods; the patients themselves who have lost immunity and are carrying microorganisms; and treatments that involve contact with medical staff and tools.

Phan Van Bau, deputy director of Ho Chi Minh City Health Department, said, "Bacterial infection at hospitals is an alarming problem."

Le Thi Anh Thu, chairwoman of Ho Chi Minh City Infection Control Society, said there are around 50 kinds of bacterial hospital infections and her deputy, Nguyen Thi Thanh Ha, said bacterial infections at hospitals is one of the leading medical challenges not only in Vietnam but the world as a whole.

It leads to serious consequences such as higher mortality rates, severe complications, longer hospitalization time (between 7 and 15 extra days), drastic increases in treatment costs, and the need to use more antibiotics, which will only increase the risk of having more superbugs, Ha said.


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"Bacteria control at hospitals has not received due attention," she said.

A ministry survey in 2012 of bacterial infection control at 522 hospitals from federal to district levels found that 40 percent did not even have a bacterial control system, while 27 percent had not developed proper management procedures to deal with the problem.

The ministry, alerted by the results, has launched a plan to significantly improve bacterial control at hospitals by 2015, with all federal, city/provincial hospitals and obstetrics clinics applying a bacterial control system.

But health experts doubt a positive outcome, saying hospitals are becoming more overcrowded and only big financial investments would fix the bacterial problems.

Dr. Bau from the HCMC Health Department said the bigger and major hospitals carry higher risks of bacterial infection as they are more crowded and engage in more complicated treatment procedures like surgeries.

Worldwide threat of anti-microbial resistance

The World Health Organization last year released a study on antimicrobial resistance, which it called "a critical health issue today."

It said the problem is not a recent phenomenon but which has evolved over several decades to "become a worldwide health threat."

The research, titled "The evolving threat of antimicrobial resistance - Options for action," was started in 2008 with inputs from more than 50 international experts in the field. They blamed the "unnecessary and inappropriate" use of antibiotics, including in the breeding of livestock.

Several kinds of bacteria have developed resistance to antibiotics has turned common infections into life-threatening ones, they said.

There were around 290,000 new multiple-drug resistant tuberculosis cases worldwide in 2010. But by the end of the next year, it said, 77 countries had already confirmed the emergence of extensively drug-resistant tuberculosis, which occurs when resistance to second-line drugs develops in addition to the resistance associated with the 2010 cases.

Western media have been reporting different cases of bacteria resistance over the past years.

A report last October by Four Corners, an Australian television program, noted the rise of a superbug form of tuberculosis in the Western Province of Papua New Guinea, close to the Australian border, due to the misuse of antibiotics.

The WHO in June 2011 said that the E. coli bacterium causing the outbreak that killed 17 people and left more than 1,500 ill across Europe was a new and more virulent strain that has never been seen before.

Most recently, My on January 19 said a 48-year-old woman in Texas, the United States had to have both her legs amputated from below the

knees and also most of her fingers, after a minor bite and scratches by her dog. The woman, Robin Sullins, became critical two days after being bitten as she tried to stop a squabble between family dogs on Christmas. She was put on life support with respirators, dialysis and feeding tubes.

Dr. Kristin Mondy, an infectious disease specialist, told My that the woman had "unusual bacteria," later identified as capnocytophaga species, which is present in the saliva of a third of cats and dogs but rarely sickens humans.

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