Tuamsuwan K.Chamawan P.Boonyarit P.Srisuphan V.Klaytong P.Rangsiwutisak C.Wannapinij P.Fongthong T.Stelling J.Turner P.Limmathurotsakul D.Mahidol University2024-08-312024-08-312024-10-01Journal of Infection Vol.89 No.4 (2024)01634453https://repository.li.mahidol.ac.th/handle/123456789/100686Objectives: To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand. Methods: We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used. Results: The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52–2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size. Conclusion: The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.MedicineArticleSCOPUS10.1016/j.jinf.2024.1062492-s2.0-852017640271532274239173918