ブータン王国の新生児集中治療室における院内感染対策の経験

Abstract

The neonatal mortality rate (NMR) in Bhutan has remained one of the highest in Asian countries. To achieve the Millennium Development Goal (MDG) 4 on child mortality (Two thirds reduction from 1990 to 2015), it is essential to reduce NMR. Royal Government of Bhutan is trying to establish neonatal care units in each Comprehensive Emergency Obstetric Care (EmOC) Centers to achieve this goal. Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) is currently the only tertiary care center and the only health facility, which has neonatal ward and Neonatal Intensive Care Unit (NICU) in the country. The author is the first Neonatologist to work in this country as a full time volunteer. This article is to share the author's experience and challenges faced regarding infection control in managing neonatal service in a resource-limited country. Nosocomial transmission of drug-resistant pathogens was intense at NICU in Bhutan; transmission involved mostly drug-resistant gram-negative bacilli. The growing burden of neonatal mortality associated with hospital-acquired neonatal sepsis in the developing world creates an urgent need for cost-effective infection-control measures in resource-limited settings. Infection-control interventions are feasible and are possibly effective in resource-limited hospital settings.