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OUCRU
In Phu Tho, a province in northern Vietnam, some districts are particularly vulnerable due to the lack of microbiological facilities. This absence of essential laboratories forces patients to travel to provincial hospitals for testing, a barrier that delays diagnosis and treatment. Without proper diagnostic tools, doctors frequently prescribe antibiotics based solely on symptoms and clinical judgment. This practice inadvertently contributes to the rise of antibiotic.
To address this issue, OUCRU and the Phu Tho Department of Health partnered to strengthen antibiotic stewardship in these resource-limited areas. Specifically, the initiative focuses on upgrading diagnostic capabilities and microbiology laboratory solutions in district-level hospitals.
Since 2022, the project introduced two microbiology solutions tailored to the specific needs of each study site. In Ha Hoa district, a mini-lab was set up, offering ready-to-use diagnostic testing for sterile samples (e.g., blood, urine, sterile fluids) directly at the district level. In Yen Lap and Tan Son districts, a hub-and-spoke model was implemented, allowing samples to be sent to a centralised, higher-level laboratory at the provincial hospital for testing.
These solutions offer healthcare providers precise data on bacterial identification and antibiotic susceptibility, enabling more targeted treatment decisions. As a result, doctors can select antibiotics that are specifically effective against the bacteria causing the infection, leading to improved patient care.
This data-driven approach reduces reliance on broad-spectrum antibiotics, minimising the risk of fostering antibiotic-resistant bacteria. Ultimately, it favours the de-escalation of therapy when appropriate and reduces unnecessary antibiotic overuse.
Beyond technological upgrades, the project equipped healthcare professionals with essential training in critical areas such as antimicrobial stewardship, clinical microbiology, ethical research conduct, and infection prevention and control.
The focus on building local capacity ensures that healthcare providers are not only supported with the necessary tools but also equipped with the knowledge to improve antibiotic use and infection control in their daily practices.
By offering hands-on training, the project has empowered healthcare professionals to make informed, evidence-based decisions that improve patient outcomes and help slow the spread of AMR. Following the conclusion of the project, the district health centres in Ha Hoa, Yen Lap, and Tan Son are committed to maintaining the improvements achieved through this initiative.
Studies are in place to ensure the ongoing operation of the mini-lab, integrate microbiology testing into routine clinical pathways, and expand the range of microbiological tests available at the district level.
Dr Vu Thi Lan Huong, Senior Research Fellow at OUCRU and Principal Investigator of the study, said: ‘Preliminary results showed a reduction in antibiotic use, both hospital-wide and in the surgical department. These results have the potential to inform policymakers and funders about the implementation model combining AMS with microbiological interventions. Further analyses are being conducted to assess the impact in more detail.’
Dr Thomas Kesteman, Clinical Microbiologist at OUCRU and Principal Investigator, said: ‘This project has proven that, in resource-limited settings, it is not only possible to implement microbiology testing, but that it supports the antimicrobial stewardship programme and vice-versa.’
Dr Luong Duy Dong, Vice Director of Ha Hoa District Health Center, said: ‘Looking ahead, we hope to maintain the microbiology laboratory at the centre and research collaborations with OUCRU.’
The ongoing commitment to training and collaboration is crucial for sustaining these improvements and creating a self-sustaining cycle of knowledge transfer and improved healthcare outcomes.