Oxford University Clinical Research Unit, Viet Nam.
Oxford University Clinical Research Unit, Viet Nam.
J Glob Antimicrob Resist. 2019 Sep;18:269-278. doi: 10.1016/j.jgar.2019.06.002. Epub 2019 Jun 12.
To establish a hospital-based surveillance network with national coverage for antimicrobial resistance (AMR) and antibiotic consumption in Viet Nam.
A 16-hospital network (Viet Nam Resistance: VINARES) was established and consisted of national and provincial-level hospitals across the country. Antimicrobial susceptibility testing results from routine clinical diagnostic specimens and antibiotic consumption data in Defined Daily Dose per 1000 bed days (DDD/1000 patient-days) were prospectively collected and analysed between October 2012 and September 2013.
Data from a total of 24 732 de-duplicated clinical isolates were reported. The most common bacteria were: Escherichia coli (4437 isolates, 18%), Klebsiella spp. (3290 isolates, 13%) and Acinetobacter spp. (2895 isolates, 12%). The hospital average antibiotic consumption was 918 DDD/1000 patient-days. Third-generation cephalosporins were the most frequently used antibiotic class (223 DDD/1000 patient-days, 24%), followed by fluoroquinolones (151 DDD/1000 patient-days, 16%) and second-generation cephalosporins (112 DDD/1000 patient-days, 12%). Proportions of antibiotic resistance were high: 1098/1580 (69%) Staphylococcus aureus isolates were methicillin-resistant (MRSA); 115/344 isolates (33%) and 90/358 (25%) Streptococcus pneumoniae had reduced susceptibility to penicillin and ceftriaxone, respectively. A total of 180/2977 (6%) E. coli and 242/1526 (16%) Klebsiella pneumoniae were resistant to imipenem, respectively; 602/1826 (33%) Pseudomonas aeruginosa were resistant to ceftazidime and 578/1765 (33%) to imipenem. Of Acinetobacter spp. 1495/2138 (70%) were resistant to carbapenems and 2/333 (1%) to colistin.
These data are valuable in providing a baseline for AMR among common bacterial pathogens in Vietnamese hospitals and to assess the impact of interventions.
建立一个覆盖全国的医院抗菌药物耐药性（AMR）和抗生素消耗监测网络。
建立了一个由 16 家医院组成的网络（Viet Nam Resistance：VINARES），包括全国和省级医院。2012 年 10 月至 2013 年 9 月期间，前瞻性收集并分析了常规临床诊断标本的药敏试验结果和每 1000 个住院日的限定日剂量（DDD/1000 患者-日）的抗生素消耗数据。
共报告了 24732 份去重的临床分离株数据。最常见的细菌是：大肠埃希菌（4437 株，18%）、克雷伯菌属（3290 株，13%）和不动杆菌属（2895 株，12%）。医院平均抗生素消耗为 918 DDD/1000 患者-日。第三代头孢菌素是使用最频繁的抗生素类别（223 DDD/1000 患者-日，24%），其次是氟喹诺酮类（151 DDD/1000 患者-日，16%）和第二代头孢菌素（112 DDD/1000 患者-日，12%）。抗生素耐药率较高：1580 株金黄色葡萄球菌中 1098 株（69%）对甲氧西林耐药（MRSA）；344 株肺炎链球菌中 115 株（33%）和 358 株肺炎克雷伯菌中 90 株（25%）对青霉素和头孢曲松的敏感性降低。2977 株大肠埃希菌中有 180 株（6%）和 1526 株肺炎克雷伯菌中有 242 株（16%）对亚胺培南耐药；1826 株铜绿假单胞菌中有 602 株（33%）对头孢他啶耐药，1765 株中有 578 株（33%）对亚胺培南耐药。2138 株不动杆菌中有 1495 株（70%）对碳青霉烯类耐药，333 株中有 2 株（1%）对黏菌素耐药。
这些数据为越南医院常见细菌病原体的 AMR 提供了基线数据，并评估了干预措施的影响。
