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

Abstract

BackgroundBloodstream 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.MethodsA 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.ResultsA 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.

Methicillin Resistant Staphylococcus Aureus;

“…22,23 Similarly, Dat et al (2017) has documented 100% sensitivity to vancomycin and linezolid, as given in our study. 24 All these findings are equally in comparison with our study.…”

Antibiotic Resistance, Biofilm Formation, and Intracellular Survival As Possible Determinants of Persistent or Recurrent Infections by Staphylococcus aureus in a Vietnamese Tertiary Hospital: Focus on Bacterial Response to Moxifloxacin

“…Data for Vietnam remain limited. 37% of staphylococci isolated from bloodstream infections in a tertiary infectious diseases hospital in North Vietnam have been reported as MRSA 10 . A similar proportion (40%) was found among isolates causing infective endocarditis in tertiary care hospitals of South Vietnam 11 .…”

Antimicrobial resistance in Cambodia: a review

“…The level of representation for each GLASS organism may partly be a reflection of their respective burdens on healthcare. A study at a tertiary hospital in Hanoi showed that K. pneumoniae and E. coli were responsible for 17.5% and 17.3% of blood stream infections (BSI) respectively (Dat et al, 2017), and, in a paediatric setting in Cambodia, Salmonella spp. were shown to be responsible for 30.4% of BSI (Fox-Lewis et al, 2018).…”