Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units

Phu, Vu Dinh; Wertheim, Heiman; Larsson, Mattias; Nadjm, Behzad; Dinh, Quynh-Dao; Nilsson, Lennart; Rydell, Ulf; Le, Tuyet Thi Diem; Trinh, Son Hong; Pham, Hung; Tran, Cang Thanh; Doan, Hanh Thi Hong; Tran, Nguyen Thua; Le, Nhan Duc; Huynh, Nhuan Van; Tran, Thao Phuong; Tran, Benjamin; Nguyen, Son Truong; Pham, Thao Thi Ngoc; Dang, Tam Quang; Nguyen, Chau; Lam, Yen Minh; Thwaites, Guy; Nguyen, Kinh Van; Hanberger, Håkan

doi:10.1371/journal.pone.0147544

Cited by 114 publications

(126 citation statements)

References 20 publications

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“…The prevalence of CRE, including CP-CRE, is high in the tertiary hospitals of the larger South Asian countries (10, 53, 62-71, 75, 82, 83, 99, 101, 102) but much lower in similar hospitals in Southeast Asia (74,114,120,121,129,134,142,147,149,150,157,161). As seen by the numerous reports of CP-CRE exportation from South and Southeast Asia (6,174,(176)(177)(178)(179)(180)(181)(182)(183)(184), international dissemination of CP-CRE appears to be a far greater problem than that of CRAB, and it will conceivably be more difficult for other countries to control CP-CRE within their own borders if this is also not tackled at its root in South and Southeast Asia.…”

Section: Discussionmentioning

confidence: 99%

“…The results from recent reports (published from 2010) are summarized in Table 5. The prevalence of CRAB in Vietnamese hospitals is very high, ranging from 43% in a pediatric hospital in Ho Chi Minh City to 92% in a tertiary referral hospital in Hanoi (142)(143)(144)(145)(146)(147). Unfortunately, the bulk of the studies were based on ICUs, where carbapenem resistance rates are usually higher (142)(143)(144)147).…”

Section: Vietnam There Is No National or Regional Antimicrobial Resimentioning

confidence: 99%

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Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

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Section: Discussionmentioning

confidence: 99%

Section: Vietnam There Is No National or Regional Antimicrobial Resimentioning

confidence: 99%

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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“…This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts [41][42][43]. However, from a study, it was partially confirmed that ICU patients would be exposed to water amoeba-associated microorganisms and provides information about the magnitude of AAM infection in ICU patients, especially patients that have a prolonged ICU stay.…”

Section: Discussionmentioning

confidence: 99%

Colonization and Antibiotic Resistance Dynamics of Patients at Intensive Care Unit (Icu)-Our Experience

Sahu

Behera²,

Swain³

2017

Asian J Pharm Clin Res

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Objective: Multidrug-resistant strains are developed day by day due to empirical therapy in intensive care unit (ICU). Both Gram-positive and Gramnegative strains are found in ICU are drug resistant bacteria. In this study, the prevalence of drug resistance bacteria in ICU were determined. Methods:The clinical samples, ascitic fluid, blood, central line tip, ET aspiration pleural fluid, pus from liver abscess, sputum, tracheal aspiration, urine, and wound swabs were collected from ICU patients and cultured in specific medium. Subsequently, antibiotic sensitivity pattern of isolated bacteria was carried out with disc diffusion methods.Results: A total number of 794 clinical samples were cultured in specific medium, and it revealed 191 of single colonies, 145 were double colonies and 87 were 3 or Multy-colonies. A total of 963 bacteria were isolated among them 180 were Gram-positive bacteria, budding yeast-like colony were 135 and rest were Gram-negative bacteria. There was no significant difference in growth of microorganisms with respect to clinical samples as t-test revealed p=0.87. Among the Gram-negative bacteria; Klebsiela pneumonia were predominant, and Proteous mirabilis was lowest. Tigecycline and colistin were most effective antibiotics agonist all bacteria.Conclusion: Urine samples of the patient's revealed a higher number of organisms whereas pus from liver abscess found only one number of growths. The antibiotic stewardship programs must lead to significant decrease in all antibiotic used in the ICU setting. However, this result may be required further work to determine the fruitful necessary for success.

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“…In this group, Acinetobacter species and P. aeruginosa are emerging as pathogens that frequently cause infections in patients with high sever consequences in intensive care units (22 including mechanisms and risk factors of development of resistance as well as the effectiveness and toxicity of various therapeutic options. In multivariate analysis, the strongest risk factors for hospital-acquired infections acquired in ICU were intubation, urinary catheter, severity of illness, involvement of a family member in patient care, and surgery after admission (23).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Class 1, 2, and 3 Integrons and Biofilm Formation in Pseudomonas aeruginosa and Acinetobacter baumannii among ICU and non-ICU Patients

Aryanezhad¹,

Shakibaie²,

Karmostaji³

et al. 2016

IEM

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Background:Infections caused by Pseudomonas aeruginosa or Acinetobacter baumannii are of greatest concern for hospitalized patients, particularly those in intensive care units (ICUs). The aims of this study were to investigate the prevalence of integrons and biofilm formation among P. aeruginosa and A. baumannii isolates collected from ICU and non-ICU inpatients. Materials and Methods: A total of 90 P. aeruginosa and 90 A. baumannii isolates were recovered from patients admitted into diverse units of Shahid Mohammadi hospital in Bandar Abbas from January to December 2014. Bacterial identification was carried out by phenotypic methods and PCR. Antibiotic susceptibility was measured by disk diffusion assay. The presence of Class 1, 2, and 3 integrons were evaluated by multiplex-PCR. Biofilm quantification was done by microtiter method. Results: The highest number of isolates (48%) were recovered from ICU patients. About 81% of P. aeruginosa isolates were sensitive to piperacillin/tazobactam and ticarcillin, while 60% were resistant to third generation of cephalosporins. In case of A. baumannii, all the isolates were sensitive to colistin, but 98% were resistant to other antibiotics (p≤0.05). Susceptibility to ceftazidime, ticarcillin, imipenem, and piperacillin/tazobactam were higher among isolates obtained from non-ICU patients. Class 1 integron was detected in 13.3% of the P. aeruginosa and 40% of the A. baumannii isolates, while Class 2 integron was harbored by 7 and 6.6% of the isolates, respectively. Furthermore, 23% of the A. baumannii and 12% of the P. aeruginosa isolates showed strong biofilm activity. Conclusion: Class 1 integron-positive isolates were resistant to three classes of antibiotics and predominantly observed in specimens collected from ICU patients showing strong biofilm.

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Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units

Cited by 114 publications

References 20 publications

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

Colonization and Antibiotic Resistance Dynamics of Patients at Intensive Care Unit (Icu)-Our Experience

Prevalence of Class 1, 2, and 3 Integrons and Biofilm Formation in Pseudomonas aeruginosa and Acinetobacter baumannii among ICU and non-ICU Patients

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