Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

• Published in: BMC infectious diseases Vol. 17; no. 1; p. 429
• Main Authors: Tran, Giang M, Ho-Le, Thao P, Ha, Duc T, Tran-Nguyen, Chau H, Nguyen, Tuyet S M, Pham, Thao T N, Nguyen, Tuyet A, Nguyen, Dung A, Hoang, Hoa Q, Tran, Ngoc V, Nguyen, Tuan V
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.06.2017; BioMed Central; BMC
• Subjects: Acinetobacter; Acinetobacter baumannii - drug effects; Acinetobacter baumannii - isolation & purification; Acinetobacter Infections - drug therapy; Acinetobacter Infections - microbiology; Age; Aged; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Bacterial infections; beta-Lactams; Cefepime; Ceftazidime; Ceftazidime - pharmacology; Ceftazidime - therapeutic use; Ceftriaxone; Ciprofloxacin; Ciprofloxacin - pharmacology; Ciprofloxacin - therapeutic use; Demographics; Developing countries; Diffusion; Drug resistance; Drug resistance in microorganisms; Drug Resistance, Bacterial - drug effects; Drugs; Ertapenem; Ethics; Female; Health aspects; Hospital patients; Hospitals; Humans; Imipenem; Imipenem - pharmacology; Infectious diseases; Intensive care; Intensive care unit; Intensive Care Units; Klebsiella; Klebsiella - drug effects; Laboratories; LDCs; Levofloxacin; Male; Medicine; Meropenem; Microbial Sensitivity Tests; Microorganisms; Middle Aged; Multidrug resistance; Nosocomial infections; Ostomy; Patients; Pharmacy; Pneumonia; Pneumonia, Ventilator-Associated - drug therapy; Pneumonia, Ventilator-Associated - microbiology; Pneumonia, Ventilator-Associated - mortality; Pseudomonas; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Risk; Risk factors; Tuberculosis; Ventilation; Ventilator-associated pneumonia; Vietnam; Vietnam; Europe; Klebsiella; Acinetobacter; Pseudomonas aeruginosa; Antimicrobial resistance; Intensive care unit
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-017-2529-z

Antimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia. Between November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient. The Bauer-Kirby disk diffusion method was used to detect the antimicrobial susceptibility. Antimicrobial resistance was commonly found in ceftriaxone (88%), ceftazidime (80%), ciprofloxacin (77%), cefepime (75%), levofloxacin (72%). Overall, the rate of antimicrobial resistance to any drug was 93% (n = 153/164), with the majority (87%) being resistant to at least 2 drugs. The three commonly isolated microorganisms were Acinetobacter (n = 75), Klebsiella (n = 39), and Pseudomonas aeruginosa (n = 29). Acinetobacter baumannii were virtually resistant to ceftazidime, ceftriaxone, piperacilin, imipenem, meropenem, ertapenem, ciprofloxacin and levofloxacin. High rates (>70%) of ceftriaxone and ceftazidime-resistant Klebsiella were also observed. These data indicated that critically ill patients on ventilator in Vietnam were at disturbingly high risk of antimicrobial resistance. The data also imply that these Acinetobacter, Klebsiella, and Pseudomonas aeruginosa and multidrug resistance pose serious therapeutic problems in ICU patients. A concerted and systematic effort is required to rapidly identify high risk patients and to reduce the burden of antimicrobial resistance in developing countries.