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Nhu, Nguyen Thi Khanh; Lan, Nguyen Phu Huong; Campbell, James I; Parry, Christopher M; Thompson, Corinne; Tuyen, Ha Thanh; Hoang, Nguyen Van Minh; Tam, Pham Thi Thanh; Le, Vien Minh; Nga, Tran Vu Thieu; Nhu, Tran Do Hoang; Van Minh, Pham; Nga, Nguyen Thi Thu; Thuy, Cao Thu; Dung, Le Thi; Yen, Nguyen Thi Thu; Van Hao, Nguyen; Loan, Huynh Thi; Yen, Lam Minh; Nghia, Ho Dang Trung; Hien, Tran Tinh; Thwaites, Louise; Thwaites, Guy; Chau, Nguyen Van Vinh; Baker, Stephen
Journal of medical microbiology, 10/2014, Letnik: 63, Številka: Pt 10Journal Article
Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that affects up to 30 % of intubated and mechanically ventilated patients in intensive care units (ICUs) worldwide. The bacterial aetiology and corresponding antimicrobial susceptibility of VAP is highly variable, and can differ between countries, national provinces and even between different wards in the same hospital. We aimed to understand and document changes in the causative agents of VAP and their antimicrobial susceptibility profiles retrospectively over an 11 year period in a major infectious disease hospital in southern Vietnam. Our analysis outlined a significant shift from Pseudomonas aeruginosa to Acinetobacter spp. as the most prevalent bacteria isolated from quantitative tracheal aspirates in patients with VAP in this setting. Antimicrobial resistance was common across all bacterial species and we found a marked proportional annual increase in carbapenem-resistant Acinetobacter spp. over a 3 year period from 2008 (annual trend; odds ratio 1.656, P = 0.010). We further investigated the possible emergence of a carbapenem-resistant Acinetobacter baumannii clone by multiple-locus variable number tandem repeat analysis, finding a blaOXA-23-positive strain that was associated with an upsurge in the isolation of this pathogen. We additionally identified a single blaNDM-1-positive A. baumannii isolate. This work highlights the emergence of a carbapenem-resistant clone of A. baumannii and a worrying trend of antimicrobial resistance in the ICU of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
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in: SICRIS
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