Göpel Lisa, My Truong Nhat, Kocer Kaan, Pham Thi Anh Mai, Linh Le Thi Kieu, Sy Bui Tien, Huber Leo, Tung Tran Thanh, The Nguyen Trong, Song Le Huu, Boutin Sébastien, Velavan Thirumalaisamy P, Nurjadi Dennis
Institute of Medical Microbiology, University of Lübeck and University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
Vietnamese-German Centre for Medical Research (VG-CARE), Hanoi, Vietnam; 108 Military Central Hospital, Hanoi, Vietnam.
J Glob Antimicrob Resist. 2025 Jul 7;44:265-271. doi: 10.1016/j.jgar.2025.07.002.
Vietnam is among the countries most affected by antimicrobial resistance in the Asia-Pacific. While multidrug-resistant Enterobacterales have been extensively studied, genomic data on multidrug-resistant Pseudomonas aeruginosa in Vietnam remains scarce. To address this, we characterized 20 carbapenem-resistant P. aeruginosa (CRPA) isolates from rectal colonization of ICU patients.
Screening for CRPA was conducted using a selective chromogenic medium (mSuperCARBA). Species identification was achieved through MALDI-TOF mass spectrometry, while antimicrobial susceptibility testing was performed using the Vitek®2 system and broth microdilution. Whole-genome sequencing was performed using the Illumina NextSeq platform.
Twenty CRPA isolates were collected from rectal swabs of 691 patients admitted to the ICUs of the 108 Military Central Hospital in Hanoi, Vietnam, between 1 July 2023 and 31 October 2023. The predominant multilocus sequence type was ST308, accounting for 50% (10/20) of the isolates. Notably, 70% (14/20) of the CRPA isolates harboured genes encoding metallo-β-lactamases (MBL), with bla being the most prevalent (86%, 12/14), followed by bla (14%, 2/14). Low susceptibility was observed for ceftazidime-avibactam (15%, 3/20) and ceftolozane-tazobactam (10%, 2/20), while cefiderocol resistance was observed in 50% (10/20) of isolates. Colistin demonstrated the most favourable susceptibility profile, with 90% (18/20) of isolates remaining susceptible.
A significant proportion of CRPA isolates in our study were MBL producers, with high levels of resistance to novel β-lactams and β-lactam/β-lactamase inhibitor combinations. These findings underscore the urgent need for effective infection prevention and control strategies to mitigate the further spread of MBL-producing CRPA.
越南是亚太地区受抗菌药物耐药性影响最严重的国家之一。虽然对多重耐药肠杆菌科细菌已有广泛研究，但越南多重耐药铜绿假单胞菌的基因组数据仍然匮乏。为解决这一问题，我们对20株来自重症监护病房（ICU）患者直肠定植的耐碳青霉烯类铜绿假单胞菌（CRPA）分离株进行了特征分析。
使用选择性显色培养基（mSuperCARBA）进行CRPA筛查。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）进行菌种鉴定，同时使用Vitek®2系统和肉汤微量稀释法进行药敏试验。使用Illumina NextSeq平台进行全基因组测序。
2023年7月1日至2023年10月31日期间，从越南河内108军事中心医院ICU收治的691例患者的直肠拭子中收集到20株CRPA分离株。主要的多位点序列类型是ST308，占分离株的50%（10/20）。值得注意的是，70%（14/20）的CRPA分离株携带编码金属β-内酰胺酶（MBL）的基因，其中bla最为常见（86%，12/14），其次是bla（14%，2/14）。头孢他啶-阿维巴坦（15%，3/20）和头孢洛扎坦-他唑巴坦（10%，2/20）的敏感性较低，而50%（10/20）的分离株对头孢地尔耐药。黏菌素显示出最有利的药敏情况，90%（18/20）的分离株仍敏感。
我们研究中的很大一部分CRPA分离株是MBL产生菌，对新型β-内酰胺类药物和β-内酰胺/β-内酰胺酶抑制剂组合具有高水平耐药性。这些发现强调了迫切需要有效的感染预防和控制策略，以减轻产MBL的CRPA的进一步传播。
