Affiliations: *National Institute of Health, Department of Medical Sciences, Nonthaburi 11000, Thailand. Tel. 662 951 0000 ext. 99415. Fax 662 589 9867,
Source: Oral presentation in The 9th Western Pacific Congress on Chemotherapy and Infectious Diseases (9th WPCCID) “Regional Infectious Disease Problems of Global Concern” December 1-5, 2004. Queen Sirikit Convention Center, Bangkok, Thailand. Program & Abstracts page 147
National Antimicrobial Resistant Surveillance (NARST) was established in the Thai-National Institute of Health (Thai-NIH) since 1998 under the sponsorship of World Health Organization and Thai Ministry of Public Health for the purpose of systematic collection, analysis, interpretation and dissemination of reliable information for planning, implementation and evaluation of public health practice.
Thirty three hospitals located in every region of Thailand participate in the program. The activities are directed by Steering Committee and consulted by the Technical Subcommittee which consists of experts from relevant fields. Technical workshop and/or seminar are regularly organized for the participants at least once a year, in order to maintain laboratory quality standards and performance . The data from each hospital are collected by the Thai-NIH and analyzed using WHONET software. After analysis, the information is disseminated country-wide by mean of brochure, annual report , and through the website: http://narst.dmsc.moph.go.th.
In 2002, the 156,104 records of the routine isolation from 29 hospitals were analysed. The result shows that 30% of Staphylococcus aureus are MRSA which is higher when compare to the 24% in 1998. Streptococcus pneumoniae isolated from sterile site has lower resistant to penicillin (33%) than from nonsterile site (48%) whereas pneumococci isolated from children <= 5 years old ishigher resistant to penicillin (61%) than patients aged more than 5 (41%). The rate of PRSP in patients aged more than 5 is steady since 1998 but PRSP isolated from children age <=5 increasing significantly from 46% in 1998 to 61% in 2002. Among common isolates of gram-negative bacteria Pseudomonas aeruginosa and Acinetobacter spp. have relatively higher resistant to imipenem. Imipinem resistant P. aeruginosa was increasing slowly from 10% in 1998 to 13% in 2002 while imipinem resistant Acinetobacter spp. was increased sharply from 2% in 1998 to 19% in 2001.
Resistant rates in Thailand are high. Resistant Surveillance Network from each country is essential and inter-country network is needed in order to have a global cooperation to combat the resistant problem.