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新型冠状病毒肺炎大流行期间重症监护病房患者的抗生素耐药性及其相关因素:一项使用越南两家医院电子病历的回顾性研究

Antibiotic resistance among ICU patients during the COVID-19 pandemic and its associated factors: a retrospective study using electronic medical records in two Vietnamese hospitals.

作者信息

Do Dang-An, Duy-Nguyen Vu-Minh, Nguyen Thi-Hang, Le Dinh-Thanh-Son, Nguyen Huy-Ngoc, Dang Duc-Nhu

机构信息

Department of Community and Global Health, https://ror.org/057zh3y96The University of Tokyo, Tokyo, Japan.

Department of Infectious Diseases, Institute of Science Tokyo, Tokyo, Japan.

出版信息

Epidemiol Infect. 2025 Jul 17;153:e93. doi: 10.1017/S0950268825100307.

Abstract

Antimicrobial resistance (AMR) in intensive care units (ICUs) is a critical issue, which has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. This study investigated AMR prevalence and its associated factors among ICU patients in two Vietnamese hospitals from January 2020 to June 2022. Electronic medical records of 1,296 patients with 2,432 non-duplicate bacterial isolates were collected in Phu Tho Hospital (Northern, rural, non-COVID-19 treatment) and 175 Hospital (Southern, urban, COVID-19 treatment centre). Antibiotic susceptibility testing was conducted using VITEK2, BD Phoenix 100, and disk diffusion methods. Logistic regression with 1,000 bootstrap resampling and cross-validation was used to examine factors linked to AMR. Results revealed (27.5%) as leading strains in Phu Tho Hospital, while (28.0%) predominated in 175 Hospital, except during 2021when reached the peak. Alarmingly, demonstrated the highest AMR rates and multidrug resistance rates (83.8%-95.8%) in both hospitals. Resistance to cephalosporins, carbapenems, and fluoroquinolones ranged from 75% to 100%. Significant associated factors included age, sex, location, initial admission diagnosis, and bacterial isolation month. This study highlights the urgent need for controlling AMR in ICUs during the pandemic.

摘要

重症监护病房(ICU)中的抗菌药物耐药性(AMR)是一个关键问题,2019年冠状病毒病(COVID-19)大流行使其更加恶化。本研究调查了2020年1月至2022年6月期间越南两家医院ICU患者中AMR的流行情况及其相关因素。在富寿医院(北部,农村,非COVID-19治疗医院)和175医院(南部,城市,COVID-19治疗中心)收集了1296例患者的电子病历,共获得2432株非重复细菌分离株。使用VITEK2、BD Phoenix 100和纸片扩散法进行抗生素敏感性测试。采用1000次自抽样重采样和交叉验证的逻辑回归分析来研究与AMR相关的因素。结果显示,在富寿医院,(27.5%)为主要菌株,而在175医院,(28.0%)占主导地位,但在2021年达到峰值时除外。令人担忧的是,在两家医院中,均表现出最高的AMR率和多重耐药率(83.8%-95.8%)。对头孢菌素、碳青霉烯类和氟喹诺酮类的耐药率在75%至100%之间。显著的相关因素包括年龄、性别、地点、初次入院诊断和细菌分离月份。本研究强调了在大流行期间控制ICU中AMR的迫切需求。

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