Bacterial bloodstream infections in a tertiary infectious diseases hospital in Northern Vietnam: aetiology, drug resistance, and treatment outcome.

Autor: Dat VQ; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam. datvq@hmu.edu.vn.; National Hospital for Tropical Diseases, Hanoi, Vietnam. datvq@hmu.edu.vn.; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam. datvq@hmu.edu.vn., Vu HN; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam., Nguyen The H; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam., Nguyen HT; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam., Hoang LB; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam., Vu Tien Viet D; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam., Bui CL; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam., Van Nguyen K; National Hospital for Tropical Diseases, Hanoi, Vietnam., Nguyen TV; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam.; National Hospital for Tropical Diseases, Hanoi, Vietnam., Trinh DT; National Hospital for Tropical Diseases, Hanoi, Vietnam., Torre A; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam., van Doorn HR; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam.; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK., Nadjm B; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam.; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK., Wertheim HFL; Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam.; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK.; Department of Medical Microbiology, Radboudumc, Nijmegen, Netherlands.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2017 Jul 12; Vol. 17 (1), pp. 493. Date of Electronic Publication: 2017 Jul 12.
DOI: 10.1186/s12879-017-2582-7
Abstrakt: Background: Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However their aetiology, antimicrobial susceptibilities and associated outcomes differ between developed and developing countries. Systematic data from Vietnam are scarce. Here we present aetiologic data on BSI in adults admitted to a large tertiary referral hospital for infectious diseases in Hanoi, Vietnam.
Methods: A retrospective study was conducted at the National Hospital for Tropical Diseases between January 2011 and December 2013. Cases of BSI were determined from records in the microbiology department. Case records were obtained where possible and clinical findings, treatment and outcome were recorded. BSI were classified as community acquired if the blood sample was drawn ≤48 h after hospitalization or hospital acquired if >48 h.
Results: A total of 738 patients with BSI were included for microbiological analysis. The predominant pathogens were: Klebsiella pneumoniae (17.5%), Escherichia coli (17.3%), Staphylococcus aureus (14.9%), Stenotrophomonas maltophilia (9.6%) and Streptococcus suis (7.6%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 25.1% (67/267 isolates) and of methicillin-resistance in S. aureus (MRSA) 37% (40/108). Clinical data was retrieved for 477 (64.6%) patients; median age was 48 years (IQR 36-60) with 27.7% female. The overall case fatality rate was 28.9% and the highest case fatality was associated with Enterobacteriaceae BSI (34.7%) which accounted for 61.6% of all BSI fatalities.
Conclusions: Enterobacteriaceae (predominantly K. pneumoniae and E. coli) are the most common cause of both community and hospital acquired bloodstream infections in a tertiary referral clinic in northern Vietnam.
Databáze: MEDLINE
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