Distribution and Antibiotic Resistance Characteristics of Bacteria Isolated from Blood Culture in a Teaching Hospital in Vietnam During 2014–2021

Abstract

Purpose Studies on the epidemiology of bloodstream infection (BSI) and antimicrobial resistance (AMR) are limited in Vietnam. Thus, the present study aimed to elucidate the epidemiology of BSI and AMR of BSI-causing bacteria in Vietnam. Methods Data regarding blood cultures from 2014 to 2021 were collected and analyzed using the chi-square test, Cochran–Armitage test, and binomial logistic regression model. Results Overall, 2405 (14.15%) blood cultures were positive during the study period. In total, 55.76% of BSIs occurred in patients aged ≥60 years. The male-to-female ratio of patients with BSI was 1.87:1. Escherichia coli (26.11%), Staphylococcus aureus (15.79%), Klebsiella pneumoniae (10.44%), Acinetobacter baumannii (4.70%), and Pseudomonas aeruginosa (3.45%) were the leading bacterial species causing BSI. The AMR rate of these bacteria isolated in the intensive care unit (ICU) was significantly higher compared with that of those in other wards. E. coli was the least resistant to carbapenems (2.39%–4.14%), amikacin (3.85%), and colistin (11.54%) and most resistant to penicillins (>80.0%). S. aureus was the least resistant to glycopeptides (0%–3.38%), quinupristin-dalfopristin (0.59%), and linezolid (1.02%) and most resistant to clindamycin (71.57%). K. pneumoniae was the least resistant to ertapenem (8.86%), amikacin (9.39%), and colistin (15.38%) and most resistant to aztreonam (83.33%). A. baumannii was the least resistant to amikacin (16.67%) and colistin (16.67%) and highly resistant to other antibiotics (≥50.0%). P. aeruginosa was the least resistant to colistin (16.33%) and piperacillin (28.17%) and highly resistant to other antibiotics (≥50.0%). Notably, the multidrug resistance rate of E. coli (76.41%) was the highest among common pathogens, followed by A. baumannii (71.57%), P. aeruginosa (64.56%), S. aureus (56.99%), and K. pneumoniae (43.72%). Conclusion The AMR rate of BSI-causing bacteria, particularly strains isolated from ICU, was alarmingly high. There is a need for new antibiotics, therapeutic strategies, as well as prevention and control to combat BSI and AMR.

Distribution and Antibiotic Resistance Analysis of Blood Culture Pathogens in a Tertiary Care Hospital in China in the Past Four Years

“…Furthermore, the VINARES report from 2016–2017 revealed that E. coli strains isolated from blood and cerebrospinal fluid samples exhibited a carbapenem resistance rate of 8%, surpassing the resistance rate observed in this study. 16 , 20 In addition, a comprehensive analysis (focusing on bloodstream infections (BSIs)) conducted from 2017 to 2019 showed that E. coli resistance to carbapenems ranged from 0.1% to 0.2%, which is consistent with the results of the present study, consistently low rates of E. coli resistance to carbapenems. 22 Meanwhile, the resistance rates for piperacillin/tazobactam and cefoperazone/sulbactam remain at a low level, which indicates that these antibacterial medications containing enzyme inhibitors could still be viable treatment options for E. coli -caused bloodstream infections.…”

“…This resistance rate closely aligns with the 56.5% reported by Wang et al, 32 underscoring the consistent and concerning trend of carbapenem resistance in Acinetobacter baumannii strains, 32 furthermore, it is noteworthy that the rate of carbapenem resistance observed in our investigation of A. baumannii bloodstream infections (BSIs) was comparatively lower than that reported in BSI studies conducted in other geographical regions. 16 , 20 , 22 In contrast, P. aeruginosa exhibits a lower resistance rate than A. baumannii , with carbapenem resistance at only approximately 5%. Data obtained from a comprehensive study conducted at a tertiary care hospital in Beijing unveiled a concerning resistance rate of 27.8% among P. aeruginosa strains towards carbapenem antibiotics.…”

The Public health problem and resistant bacteria in lowand middle-income countries

“…However, many studies focus on various aspects of AMR occurrence and "frequency" in the health system, society, and the environment. Three studies conducted in Cameroon, Morocco, and Vietnam showed Enterobacteriaceae as the most frequently isolated microorganisms, followed by S. aureus, as we determined, but Camara N. and Haeeb A. determined an opposite situation in Tanzania and Saudi Arabia (2,9,27,28,29). When analyzing isolates according to the source (biosubstrate), studies focusing on uropathogens showed that E. coli is the most frequent uropathogen followed by K. pneumoniae (in Ethiopia and USA), compared to 2 studies from Romania showing 2 distinct situations -one study showed a similar situation as in Ethiopia, and the second one showed a distinct situation -with P. aeruginosa on the first place similar to the one in Mexico (14, 25, 30 31, 32).…”

“…It should be noted that antimicrobial-resistant pathogens not only cause an increased number of deaths (mortality caused by multi-drug resistant (MDR) P. aeruginosa reaches up to 61% of cases, and pan-drug resistant (PDR) K. pneumoniaemaximum 71%) and disability, but also additional costs for hospitalization, treatment, and recovery, which cannot be accurately calculated (5,8,9). Specialists from various countries have concluded that the economic status of a country significantly influences the impact of AMR on the population, largely due to investment size in surveillance systems for antimicrobial resistance of microorganisms, but also to the presence and quality of alternative resources that can be used to fight infections (10).…”

Genomic Determinants of Pathogenicity and Antimicrobial Resistance of Nosocomial Acinetobacter baumannii Clinical Isolates of Hospitalized Patients (2019–2021) from a Sentinel Hospital in Hangzhou, China

“…Isolates were nonsusceptible to ≥1 agent in ≥3 antimicrobial classes were considered multi-drug resistant (MDR). 27 , 28 The tested antimicrobials and their detection concentration are mentioned in Table S1 .…”