Aligning Antimicrobial Stewardship and Infection Prevention Through Repeated Assessment and Feedback: A Multisite Quality Improvement Initiative in Viet Nam.

Authors

Quoc Phuong Nguyen, Van Giang Tran, Hai Yen Nguyen, Thi Phuong Oanh Pham, Trung Cap Nguyen, Minh Dien Vu, Anh Cuong Tran, Thi Ngoc Diep Nguyen, Van Minh Nguyen, Ba Hai Mai, Bao Dung Vo, Thanh Bao Nguyen, Dinh Phu Vu, Thi Thuy Van Pham, Thi Bich Ngoc Hoang, H Rogier van Doorn, Thomas Kesteman, Huong Thi Lan Vu

Published in

Open forum infectious diseases. Volume 13. Issue 10. Pages ofag605. Epub Oct 10, 2026.

Abstract

Antimicrobial stewardship (AMS) and infection prevention and control (IPC) are complementary strategies to improve patient safety and address antimicrobial resistance (AMR). In low- and middle-income countries (LMICs), they are often implemented separately, limiting potential impact.
To evaluate the feasibility of an aligned AMS-IPC improvement approach and describe changes in implementation in Vietnamese hospitals.
We conducted a quality improvement initiative in 4 hospitals within the national AMR surveillance network in Viet Nam (March-September 2025). We used US-CDC's tools to guide implementation, including the Global Antibiotic Stewardship Evaluation Tool (G-ASET) and the Infection Control Assessment and Response (ICAR) tool. Baseline assessments were followed by feedback, multidisciplinary action planning, and targeted capacity building. Follow-up occurred 2-5 months later. Changes were analyzed descriptively using quantitative scores and qualitative synthesis and reported following the SQUIRE 2.0 guidelines.
All hospitals had established IPC programs at baseline, while AMS maturity varied. G-ASET scores increased across all sites, with larger absolute gains in hospitals starting from lower baselines. Improvements were seen in leadership and governance, education and training, stewardship actions, and monitoring and reporting. Selected IPC activities aligned with AMS priorities also improved, particularly transmission-based precautions, environmental cleaning, and cross-team coordination. Infrastructure-dependent areas, such as water safety, showed limited short-term progress.
This aligned AMS-IPC quality improvement strategy was feasible and associated with improvements in implementation capacity and program maturity over short follow-up. Further studies with longer follow-up, comparator designs, and outcome-level measures are needed to evaluate effectiveness, sustainability, and generalizability.

PMID:
42859714
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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