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This thesis not only provided a picture of IPC in both Dongguan city and Mainland China, but also objectively and comprehensively evaluated the current status of outcome indicator surveillance and the implementation of IPC strategies in China.

The results allowed comparison with national and international data sources; and thus, contributed Chinese data to the global health perspective.

Our research established a good example for Asian countries to evaluate and improve outcome indicators, particularly for prospective AMR surveillance. We applied a standardised protocol (EARS-Net protocol) for the AMR burden estimation, which allows for geographical comparisons between Asia and Europe. Although our

findings in this research could not be representative for the situation of Asia, to variable degrees, it can elevate the visibility of IPC and promote the implementation of the outcome indicator surveillance in difference Asian countries, where are lacking of outcome indicators surveillance data and public reporting.

This research provides valuable evidence to convince hospital managers, policy makers, and other stakeholders for development of their own local IPC strategies in terms of WHO recommendations. Furthermore, the gaps of IPC identified by this research may also reflect the same situations in other Asian countries. Policy makers should tailor and prioritize on important core/key components implementation in terms of local socioeconomic status and medical resources.

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ANNEXES

Article 1

- Wang J, Hu J, Harbarth S, Pittet D, Zhou M, Zingg W: Burden of healthcare-associated infections in China: results of the 2015 point prevalence survey in Dong Guan City. J Hosp Infect 2017, 96(2):132-138.

https://www.ncbi.nlm.nih.gov/pubmed/28325579 Article 2

- Wang J, Liu F, Tartari E, Huang J, Harbarth S, Pittet D, Zingg W: The Prevalence of Healthcare-Associated Infections in Mainland China: A Systematic Review and Meta-analysis. Infect Control Hosp Epidemiol 2018, 39(6):701-709.

https://www.ncbi.nlm.nih.gov/pubmed/29655388 Article 3

- Wang J, Zhou M, Huang G, Guo Z, Sauser J, Metsini A, Pittet D, Zingg W:

Antimicrobial resistance in Southern China: Results of prospective surveillance in Dong Guan City, 2017. J Hosp Infect 2020, 105(2):188-196.

https://pubmed.ncbi.nlm.nih.gov/32243952/

Article 4

- Wang J, Liu F, Tan JBX, Harbarth S, Pittet D, Zingg W: Implementation of infection prevention and control in acute care hospitals in Mainland China - a systematic review. Antimicrob Resist Infect Control 2019, 8:32.

https://www.ncbi.nlm.nih.gov/pubmed/30792854 Article 5

- Wang J, Zhou M, Hesketh T, Kritsotakis EI: Clinical impact of third generation cephalosporin-resistance in Enterobacteriaceae infections: a multicenter cohort study in Southern China. Am J Infect Control 2020 (Under Review)

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