Van Trang Dinh, Dinh Quynh-Dao, Vu Phu Dinh, Nguyen Trung Vu, Pham Ca Van, Dao Trinh Tuyet, Phung Cam Dac, Hoang Ha Thu Thi, Tang Nga Thi, Do Nga Thuy, Nguyen Kinh Van, Wertheim Heiman
National Hospital of Tropical Diseases, Hanoi, Viet Nam.
Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam.
J Glob Antimicrob Resist. 2014 Dec;2(4):318-321. doi: 10.1016/j.jgar.2014.05.003.
complex is a common cause of hospital-acquired infections (HAIs) globally, remarkable for its high rate of antibiotic resistance, including to carbapenems. There are few data on the resistance of in Vietnam, which are essential for developing evidence-based treatment guidelines for HAIs. Antibiotic susceptibility testing was conducted by VITEK2, and pulsed-field gel electrophoresis (PFGE) was performed on 66 clinical complex isolates recovered during 2009 at the National Hospital of Tropical Diseases (NHTD), a referral hospital in Hanoi, Vietnam. Basic demographic and clinical data were collected and analysed using descriptive statistics. Most isolates came from lower respiratory tract specimens (59; 89.4%) from intensive care unit (ICU) patients [64/65 (98.5%) with available data] who had been admitted to NHTD for ≥2 days [42/46 (91.3%) with available data]. More than 90% of the isolates were resistant to the tested β-lactamase/β-lactamase inhibitors, cephalosporins, carbapenems, fluoroquinolones and trimethoprim/sulfamethoxazole. Moreover, 25.4% (16/63) were resistant to all tested β-lactams, quinolones and aminoglycosides. All isolates remained sensitive to colistin and 58.7% were susceptible to tigecycline. Of the 66 isolates, 49 could be classified into eight PFGE types (A-H). Every PFGE type, except D, had cluster(s) of three or more isolates with a temporal relationship. In conclusion, these data suggest a significant rise in antibiotic resistance in Vietnam. Clustering within PFGE types supports cross-transmission of within the ICU at NHTD. Increased research and resources in optimising treatment, infection control and antibiotic stewardship are needed.
在全球范围内,[具体病原体名称]是医院获得性感染(HAIs)的常见原因,其以高抗生素耐药率而著称,包括对碳青霉烯类抗生素的耐药。越南关于[具体病原体名称]耐药性的数据很少,而这些数据对于制定基于证据的医院获得性感染治疗指南至关重要。采用VITEK2进行抗生素敏感性测试,并对2009年期间在越南河内的一家转诊医院——国家热带病医院(NHTD)分离出的66株临床[具体病原体名称]菌株进行脉冲场凝胶电泳(PFGE)分析。收集基本人口统计学和临床数据,并使用描述性统计方法进行分析。大多数菌株来自重症监护病房(ICU)患者的下呼吸道标本(59份;89.4%),这些患者入住NHTD≥2天[42/46(91.3%)有可用数据],且64/65(98.5%)有可用数据。超过90%的菌株对所测试的β-内酰胺酶/β-内酰胺酶抑制剂、头孢菌素、碳青霉烯类抗生素、氟喹诺酮类抗生素和甲氧苄啶/磺胺甲恶唑耐药。此外,25.4%(16/63)对所有测试的β-内酰胺类抗生素、喹诺酮类抗生素和氨基糖苷类抗生素耐药。所有菌株对黏菌素仍敏感,58.7%对替加环素敏感。在66株菌株中,49株可分为8种PFGE型(A-H)。除D型外,每种PFGE型都有三个或更多具有时间关系的菌株簇。总之,这些数据表明越南[具体病原体名称]的抗生素耐药性显著上升。PFGE型内的聚类支持了[具体病原体名称]在NHTD的ICU内的交叉传播。需要增加研究和资源以优化治疗、感染控制和抗生素管理。