Le Hoang Huy, Nguyen An Van, Vu Luong Huy, Nguyen Vinh Thi Ha, Pham Hoa Quynh, Le Hung Van, Nguyen Son Thai, Le Hong Thu, Dinh Hung Viet, Le Nam Van, Le Tuan Dinh, Le Minh Nhat, Nguyen Viet Hoang, Hoang Kien Trung, Le Hai Ha Long
Department of Bacteriology, National Institute of Hygiene and Epidemiology, Vietnam.
Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Vietnam.
Jpn J Infect Dis. 2024 May 23;77(3):144-154. doi: 10.7883/yoken.JJID.2023.260. Epub 2024 Jan 31.
This cross-sectional study investigated the antimicrobial resistance (AMR) patterns of gram-negative pathogens isolated from 4,789 hospitalized patients with lower respiratory tract infections (LRTIs). Of the collected specimens, 1,325 (27.7%) tested positive for gram-negative bacteria. Acinetobacter baumannii (38.6%), Pseudomonas aeruginosa (33.5%), Klebsiella pneumoniae (18.7%), Escherichia coli (5.6%), and Klebsiella aerogenes (3.5%) were the most prevalent isolates. AMR analysis revealed high resistance rates (79.9%-100%) of A. baumannii isolates to multiple classes of antibiotics except amikacin, trimethoprim/sulfamethoxazole, and colistin. P. aeruginosa displayed low resistance to colistin (< 10%) but high resistance to other antibiotics. K. pneumoniae displayed high resistance rates of 90.0%-100.0% to most penicillins, whereas resistance rates were notably lower for colistin (7.1%) and amikacin (16.7%). K. aerogenes exhibited high resistance to various antibiotics and sensitivity to amikacin (95.1%), ampicillin (100.0%), and colistin (100.0%). E. coli isolates exhibited resistance to ampicillin (96.9%) and maximum sensitivity to several antibiotics. Our study identified significant AMR trends and highlighted the prevalence of multidrug-resistant strains (93.6% for K. aerogenes and 69.1%-92.4% for other isolates). These findings emphasize the urgent need for appropriate antibiotic management practices to combat AMR in gram-negative pathogens associated with LRTIs.
这项横断面研究调查了从4789例住院的下呼吸道感染（LRTIs）患者中分离出的革兰氏阴性病原体的抗菌耐药性（AMR）模式。在收集的标本中，1325份（27.7%）革兰氏阴性菌检测呈阳性。鲍曼不动杆菌（38.6%）、铜绿假单胞菌（33.5%）、肺炎克雷伯菌（18.7%）、大肠埃希菌（5.6%）和产气克雷伯菌（3.5%）是最常见的分离株。AMR分析显示，除阿米卡星、甲氧苄啶/磺胺甲恶唑和黏菌素外，鲍曼不动杆菌分离株对多类抗生素的耐药率较高（79.9%-100%）。铜绿假单胞菌对黏菌素的耐药性较低（<10%），但对其他抗生素的耐药性较高。肺炎克雷伯菌对大多数青霉素的耐药率高达90.0%-100.0%，而对黏菌素（7.1%）和阿米卡星（16.7%）的耐药率明显较低。产气克雷伯菌对多种抗生素具有高耐药性，对阿米卡星（95.1%）、氨苄西林（100.0%）和黏菌素（100.0%）敏感。大肠埃希菌分离株对氨苄西林具有耐药性（96.9%），对几种抗生素的敏感性最高。我们的研究确定了显著的AMR趋势，并强调了多重耐药菌株的流行情况（产气克雷伯菌为93.6%，其他分离株为69.1%-92.4%）。这些发现强调了迫切需要采取适当的抗生素管理措施，以对抗与LRTIs相关的革兰氏阴性病原体中的AMR。
