Clinical and microbiological evaluation of ventilator-associated pneumonia in an intensive care unit in Vietnam.

Autor:	Hayakawa K; 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., Binh NG; Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam., Co DX; Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam., Thach PT; Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam., Phuong Thuy PT; National Center for Global Health and Medicine - Bach Mai Hospital Medical Collaboration Center, Hanoi, Vietnam., Chau NQ; Respiratory Department, Bach Mai Hospital, Hanoi, Vietnam.; Tam Anh General Hospital, Hanoi, Vietnam., Huong ML; Microbiology Department of Bach Mai Hospital, Hanoi, Vietnam., Van Thanh D; International Department, Bach Mai Hospital, Hanoi, Vietnam., Phuong DM; Microbiology Department of Bach Mai Hospital, Hanoi, Vietnam., Miyoshi-Akiyama T; Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan., Nagashima M; Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan., Ohmagari N; 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.
Jazyk:	angličtina
Zdroj:	Infection prevention in practice [Infect Prev Pract] 2023 Oct 30; Vol. 5 (4), pp. 100318. Date of Electronic Publication: 2023 Oct 30 (Print Publication: 2023).
DOI:	10.1016/j.infpip.2023.100318
Abstrakt:	Background: 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. Methods: 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 Acinetobacter baumannii isolates. Results: 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 ( N =35, 28%). Acinetobacter baumannii was most frequently isolated in the first VAP episode ( N =84, 67.2%) and was multiply resistant to meropenem, levofloxacin, and amikacin. The 30-day mortality rate was 55.2% ( N =69) and higher in patients infected with A. baumannii ( N =52, 65%). WGS results suggested a complex spread of multiple clones. Conclusions: In an intensive care unit in Vietnam, VAP due to A. baumannii had a high mortality rate, and A. baumannii and K. pneumoniae were multidrug resistant, with carbapenem resistance of 97% and 70%, respectively. (© 2023 The Authors.)
Databáze:	MEDLINE
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