Hayakawa Kayoko, Binh Nguyen Gia, Co Dao Xuan, Thach Pham The, Phuong Thuy Pham Thi, Chau Ngo Quy, Huong Mai Lan, Van Thanh Do, Phuong Doan Mai, Miyoshi-Akiyama Tohru, Nagashima Maki, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
Infect Prev Pract. 2023 Oct 30;5(4):100318. doi: 10.1016/j.infpip.2023.100318. eCollection 2023 Dec.
The increasing incidence of multidrug-resistant Gram-negative bacteria causing ventilator-associated pneumonia (VAP) is a global concern. A better understanding of the epidemiology of VAP in Southeast Asia is essential to optimise treatments and patient outcomes.
VAP epidemiology in an intensive care unit in Vietnam was investigated. A prospective cohort study was conducted. Patients who were ventilated for >48 hours, diagnosed with VAP, and had a positive respiratory culture between October 2015 and March 2017 were included. Whole-genome sequencing (WGS) was performed on isolates.
We identified 125 patients (137 episodes) with VAP from 1,699 admissions. Twelve patients had 2 VAP episodes. The median age was 60 years (interquartile range: 48-70), and 68.8% of patients were male. Diabetes mellitus was the most frequent comorbidity (=35, 28%). was most frequently isolated in the first VAP episode (=84, 67.2%) and was multiply resistant to meropenem, levofloxacin, and amikacin. The 30-day mortality rate was 55.2% (=69) and higher in patients infected with (=52, 65%). WGS results suggested a complex spread of multiple clones.
In an intensive care unit in Vietnam, VAP due to had a high mortality rate, and and were multidrug resistant, with carbapenem resistance of 97% and 70%, respectively.
引起呼吸机相关性肺炎（VAP）的多重耐药革兰氏阴性菌发病率不断上升，这是一个全球关注的问题。更好地了解东南亚VAP的流行病学对于优化治疗和患者预后至关重要。
对越南一家重症监护病房的VAP流行病学进行了调查。开展了一项前瞻性队列研究。纳入了2015年10月至2017年3月期间接受机械通气超过48小时、被诊断为VAP且呼吸道培养结果呈阳性的患者。对分离株进行了全基因组测序（WGS）。
我们从1699例入院患者中识别出125例（137次发作）VAP患者。12例患者有2次VAP发作。中位年龄为60岁（四分位间距：48 - 70岁），68.8%的患者为男性。糖尿病是最常见的合并症（n = 35，28%）。[具体细菌名称]在首次VAP发作中最常被分离出来（n = 84，67.2%），并且对美罗培南、左氧氟沙星和阿米卡星多重耐药。30天死亡率为55.2%（n = 69），感染[具体细菌名称]的患者死亡率更高（n = 52，65%）。WGS结果表明多个克隆存在复杂传播。
在越南的一家重症监护病房，由[具体细菌名称]引起的VAP死亡率很高，[具体细菌名称1]和[具体细菌名称2]具有多重耐药性，碳青霉烯类耐药率分别为97%和70%。
