Biedenbach Douglas J, Bouchillon Samuel K, Hoban Daryl J, Hackel Meredith, Phuong Doan Mai, Nga Tran Thi Thanh, Phuong Nguyen Tran My, Phuong Tran Thi Lan, Badal Robert E
International Health Management Associates, Inc., Schaumburg, IL, USA.
International Health Management Associates, Inc., Schaumburg, IL, USA.
Diagn Microbiol Infect Dis. 2014 Aug;79(4):463-7. doi: 10.1016/j.diagmicrobio.2014.05.009. Epub 2014 May 17.
Treatment options for multidrug-resistant pathogens remain problematic in many regions and individual countries, warranting ongoing surveillance and analysis. Limited antimicrobial susceptibility information is available for pathogens from Vietnam. This study determined the bacterial susceptibility of aerobic gram-negative pathogens of intra-abdominal infections among patients in Vietnam during 2009-2011. A total of 905 isolates were collected from 4 medical centers in this investigation as part of the Study for Monitoring Antimicrobial Resistance Trends. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) rates among the appropriate species were determined by a central laboratory using Clinical and Laboratory Standards Institute methods. Among the species collected, Escherichia coli (48.1% ESBL-positive) and Klebsiella pneumoniae (39.5% ESBL-positive) represented the majority (46.4%) of the isolates submitted for this study. Ertapenem MIC90 values were lowest for these 2 species at 0.12 and 0.25μg/mL and remained unchanged for ESBL-positive isolates. Imipenem MIC90 values were also the same for all isolates and ESBL-positive strains at 0.25 and 0.5μg/mL, respectively. Ertapenem MIC90 values for additional species with sufficient numbers for analysis, including Enterobacter cloacae, Proteus mirabilis, Acinetobacter baumannii, and Pseudomonas aeruginosa, were 1, 0.06, >4, and >4μg/mL, respectively. Analysis of beta-lactamases in a subset of 132 phenotypically ESBL-positive Enterobacteriaceae demonstrated that CTX-M variants, particularly CTX-M-27 and CTX-M-15, were the predominant enzymes. High resistance rates in Vietnam hospitals dictate continuous monitoring as antimicrobial inactivating enzymes continue to spread throughout Asia and globally.
在许多地区和个别国家，耐多药病原体的治疗选择仍然存在问题，因此有必要持续进行监测和分析。越南病原体的抗菌药敏信息有限。本研究确定了2009年至2011年期间越南患者腹腔内感染的需氧革兰氏阴性病原体的细菌药敏情况。作为监测抗菌药物耐药性趋势研究的一部分，本调查从4个医疗中心共收集了905株分离菌。由一个中央实验室采用临床和实验室标准协会的方法确定了相应菌种的抗菌药敏和超广谱β-内酰胺酶（ESBL）发生率。在所收集的菌种中，大肠埃希菌（ESBL阳性率为48.1%）和肺炎克雷伯菌（ESBL阳性率为39.5%）占本研究提交的分离菌的大多数（46.4%）。这两种菌种的厄他培南MIC90值最低，分别为0.12和0.25μg/mL，ESBL阳性分离菌的该值保持不变。亚胺培南的MIC90值在所有分离菌和ESBL阳性菌株中也相同，分别为0.25和0.5μg/mL。对有足够数量进行分析的其他菌种，包括阴沟肠杆菌、奇异变形杆菌、鲍曼不动杆菌和铜绿假单胞菌，其厄他培南MIC90值分别为1、0.06、>4和>4μg/mL。对132株表型为ESBL阳性的肠杆菌科细菌的一个子集进行β-内酰胺酶分析表明，CTX-M变体，特别是CTX-M-27和CTX-M-15，是主要的酶。越南医院的高耐药率表明需要持续监测，因为抗菌失活酶继续在亚洲和全球传播。
