1. Project title
The Project for Human resource development through “Infection Prevention and Control (IPC)” and“Antimicrobial Stewardship Program (ASP) for Antimicrobial resistance (AMR) response inIndonesia
2. Country nameIndonesia
3. BackgroundIndonesia has tried to strengthen measures against antimicrobial resistance (AMR). Sulianti Saroso
Infectious Disease Hospital(SSIDH) is a top referral hospital of Indonesia in the field of infectious
disease prevention and control. However, "The Antimicrobial Resistant Stewardship Committee" ofthis hospital was established in 2017, and it is still new. There is room for improvement insurveillance system of nosocomial infections in this hospital, because the rate of nosocomial
infections such as catheter-related blood stream infections is unknown scientifically. Regarding thedetection frequency of drug-resistant bacteria, it is reported as very high. 65% of Acinetobacter spp.,
which cause nosocomial infection, is carbapenem resistant. This condition poses a significant
challenge for AMR responses. Inappropriate use of antimicrobial is considered as one of risk factorsof ventilator-associated pneumonia (VAP) that is caused by multi drug resistance. Thus, it isnecessary to strengthen monitoring and evaluation (M&E) of antimicrobial use and AMR.
Simultaneously, quality of oral care should be improved, because oral care can be expected to prvent
VAP.
4. Objective
This project aims to strengthen capacities of comprehensive Infection Prevention and Control (IPC)and Antimicrobial Stewardship Program (ASP) at SSIDH.
[The objectives of the second year]
To develop a surveillance of blood stream infections for effective implementation of ASP.
To improve quality of surveillance through training on collection process of blood culture.
To raise awareness of importance of oral care in nosocomial infection prevention through capacity
building training.
5. Program outline
・April-July: Preparation meeting for workshop, sureillance and the activity schedule
・August: Workshop on facility-based surveillance of blood stream infections and oral care inIndonesia
・Decemer:Workshop on facility-based surveillance of blood stream infections and oral care inIndonesia
・January: Oral care workshop in Japan
6. Implementation structure
6-1. Japanese side
Program manager: Satsoshi Kutsuna
・NCGM Disease Control and Prevention Center (Department of Infectious Disease, AMRCRC)；5to 6 staff members
・NCGM Dental Oral Surgery；4 to 5 staff members
・NCGM Pharmaeutical Department; 1 staff members
・MCGM Central Clinical Laboratory Department; 1 staff members· Niigata University (WHO Cooperation Center: Oral Health Promotion)
・Company: SARAYA, SUNSTAR
6-2. Counterpart country side

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Staff members engaged in the antimicrobial stewardship program and Infection Prevention Conrol
at Sulianti Saroso Infectious Disease Hospital (SSIDH) in Indonesia

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7. Indicator
1. Workshop in Japan （Jan 2021）
・6 staff members engaged in the antimicrobial stewardship program and Infection
Prevention Conrol (IPC) from SSIDH
・5 % increase in pre and post test
7-1. Output
2. Workshop in Indonesia
・15 staff members engaged in IPC and the antimicrobial stewardship program(surveyllance, blood culture, oral care) from SSIDH
・5 % increase in pre and post test
1. Surveyllance of catheter-related blood stream infections is launched at SSIDH forthe forst time.
2. Increase in the sample number of boold culture （more than 5％）
3. Oral care skills is applied in direct patient case after the workshop.
7-2. Outcome
4. Monitoring and evaluation of handrub consumptino is implemented. 5 % increasein consumption compared with the one of January 2020.
In the third year
Surveyllance of catheter-related blood stream infections is established at SSIDH.
Skills on advanced IPC are disseminated from SSIDH to other local hospitals.
1. Increase of medical facilities that carry out surveyllance of catheter-related bloodstream infections
7-3. Impact

2. Disseminate oral care in Indonesia nationwide. Promote sponge brush for oral
care；Expand sales channel of Sunstar oral care products3）Recommendation to Indonesian Ministry of Health on facility-based IPC and ASP
model including surveyllance and oral care
8. Main activities
8-1. Training in 2020

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Workshop on facility-based surveillance of blood stream infections and oral care inIndonesia (Dispatch five experts from NCGM and two experts from private sector for twodays in August.)
Workshop on facility-based surveillance of blood stream infections and oral care inIndonesia (Dispatch four experts from NCGM for two days in October.)3)

Workshop on facility-based surveillance of blood stream infections and oral care inIndonesia (Dispatch five experts from NCGM for two days in December.)

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4)Workshop training on oral care in Japan 2021 (Receive six trainees from SSIDH for fourdays including two days for international travel.)

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