Coming almost three years after the construction of Thakhek Hospital’s microbiology laboratory, this seminar allowed for the creation of an inventory on: hospital ecology, epidemics and known resistant strains. Diagnoses of particular interest in the laboratory were 14 cases of melioidosis, a disease prevalent in South East Asia and caused by Burkholderia pseudomallei – (isolation of the germ having allowed the introduction of Ceftazidime in the hospital’s treatment programme) – 6 known cases of typhoid fever (strains susceptible to regular antibiotics), and numerous other enterobacteria infections of which almost a quarter secrete Extended Spectrum Beta-Lactamase (ESBL) were diagnosed in the laboratory, and as a result of its acquired resistance, have a strong potential to become epidemic. At times bringing doctors to a dead end with regards to treatment, Carbapenems are not available in Laos.
Very few laboratories in Laos provide bacterial cultures, and this seminar was the opportunity to show the working of a true laboratory; outlining the identification of bacteria, antibiogram, and hygiene and biosecurity protocol were also included. The presence of two international volunteers (Elodie Luangkhot in 2010 and Caroline Leyer in 2011) thanks to the support of the Rhone Alpes region, underlined the great misuse of antibiotics in Laos, prescribed without doctor’s instructions and often with only minimal knowledge. Led by Dr Monique Chomarat, Dr Meja Rabodonirina and Dr Elisabeth Borel, biologists from the Hospices of Lyon and the Claude Bernard University of Lyon, conferences have been organised around the following themes: antiobiotic targets and resistance mechanisms, ground rules for their use in treatment, microbiological sampling and parasitic diarrhoea.
Lastly, this seminar was intended to provoke thinking around the creation of a laboratory network for the province, so that expertise and skills developed at Thakhek can be shared with surrounding hospitals. Continuous training, quality controls and health monitoring are the issues that have been addressed, with calls now for local and national plans of action.