Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam

Abstract

BackgroundAntimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia.MethodsBetween November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient. The Bauer–Kirby disk diffusion method was used to detect the antimicrobial susceptibility.ResultsAntimicrobial resistance was commonly found in ceftriaxone (88%), ceftazidime (80%), ciprofloxacin (77%), cefepime (75%), levofloxacin (72%). Overall, the rate of antimicrobial resistance to any drug was 93% (n = 153/164), with the majority (87%) being resistant to at least 2 drugs. The three commonly isolated microorganisms were Acinetobacter (n = 75), Klebsiella (n = 39), and Pseudomonas aeruginosa (n = 29). Acinetobacter baumannii were virtually resistant to ceftazidime, ceftriaxone, piperacilin, imipenem, meropenem, ertapenem, ciprofloxacin and levofloxacin. High rates (>70%) of ceftriaxone and ceftazidime-resistant Klebsiella were also observed.ConclusionThese data indicated that critically ill patients on ventilator in Vietnam were at disturbingly high risk of antimicrobial resistance. The data also imply that these Acinetobacter, Klebsiella, and Pseudomonas aeruginosa and multidrug resistance pose serious therapeutic problems in ICU patients. A concerted and systematic effort is required to rapidly identify high risk patients and to reduce the burden of antimicrobial resistance in developing countries.

Difficult-to-Treat Antibiotic-Resistant Gram-Negative Pathogens in the Intensive Care Unit: Epidemiology, Outcomes, and Treatment

“…35 A single-center ICU study from Vietnam indicates that 90.5% of Acinetobacter, 86.2% of P. aeruginosa, and 20.0% of Klebsiella respiratory isolates are resistant to meropenem. 36 In an ICU in India the overall rate of MDR-gram negatives is 55.7% with the highest rate being Acinetobacter spp at 82.1%. 37 In this study the rate of MDR-P. aeruginosa was 56.9% and the rate of MDR-Klebsiella spp and MDR-E. coli were 52.4 and 26.3%, respectively.…”

Pseudomonas aeruginosa Antimicrobial Susceptibility Results at a State Hospital in Turkey (2010-2016)

“…Antimikrobiyal direncinin global bir sorun olduğu, gelişmekte olan ülkeler başta olmak üzere tüm dünyadaki insanları etkilediği bildirilmiştir (16) . Ciddi P.aeruginosa infeksiyonlarında uygun olmayan başlangıç antimikrobiyal tedavisi ve/veya uygun tedavinin gecikmesi mortalitenin artması ve hastanede kalış süresinin uzamasıyla ilişkili bulunmuştur.…”

“…Çok sayıda çalışmada P.aeruginosa için en etkili antibiyotiğin kolistin ve amikasin olduğu bildirilmiştir (6,8,10,14,16,17) . Sader ve ark.…”

“…Güney Amerika'da (10,12) % 42.8-62.8. Asya-Kuzey pasifik'de (2,6,7,12,16) % 0-86.2. Avrupa'da (5,12,13) % 14.5-39.7.…”

Synthesis, Characterization, and Antibacterial Activity of Some Novel 5-Chloroisatin Derivatives

“…This requires exploring and synthesizing a new class of effective antimicrobial compounds that are part of the family of 5-Chloroisatin derivatives against pathogenic microorganisms that have developed resistance to antibiotics used in the current regime. The 5-Chloroisatin derivates are an important class of organic compounds, some of which show significant biological like antibacterial, antiviral, antifungal [2], anti-inflammatory [3], analgesic [4], anti-tubercular [5] and antidepressant [6]. In view of these facts, we envisaged synthesizing new dipolarophiles, isoxazoles and 1, 2, 3-triazoles derived from 5-Chloroisatin, successively by the following methods, N-alkylation, 1, 3-Dipolar Cycloaddition by nitrile oxides and Azides.…”