Burden and resistance of Gram-negative pathogens in ICU-acquired infections in Vietnam: a cross-sectional study

Do Quoc  Phong; Vu Hai  Vinh; Dang Hai  Van; Tran Minh  Hieu; Tran Thi Mai  Huong; Le Thi  Thuong; Le Huynh  Duc; Nguyen Thi Mai  Huong

doi:10.18502/ijm.v18i1.20904

Do Quoc Phong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Vu Hai Vinh Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Dang Hai Van Department of Infection Control, E Hospital, Hanoi, Vietnam
Tran Minh Hieu Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Tran Thi Mai Huong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Le Thi Thuong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Le Huynh Duc Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam
Nguyen Thi Mai Huong Medical Check-up Clinic, E Hospital, Hanoi, Vietnam

DOI: https://doi.org/10.18502/ijm.v18i1.20904

Keywords: Hospital-acquired infection; Gram-negative bacteria; Drug resistance; Microbial; Intensive care units; Pneumo- nia; Ventilator-associated; Antimicrobial stewardship

Abstract

Background and Objectives: This study aimed to describe the burden, pathogen distribution, antimicrobial resistance pat- terns, and selected clinical outcomes of intensive care unit (ICU)-acquired Gram-negative bacteria (GNB) infections in Vietnam, with exploratory comparative analyses of outcomes.

Materials and Methods: A retrospective descriptive study with comparative analyses was conducted among 102 adult pa- tients with culture-confirmed ICU-acquired GNB infections at E Hospital, Hanoi. Demographic, clinical, microbiological, and outcome data were extracted from medical records. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute guidelines. Comparisons between outcome groups were assessed using chi- square test, with effect sizes quantified using Cramer’s V.

Results: Pneumonia was the predominant infection (70.5%), followed by urinary tract (15.2%) and bloodstream infections (10.6%). GNB accounted for 68.3% of all hospital-acquired infections (HAIs), with Acinetobacter baumannii (43.4%), Pseudomonas aeruginosa (24.8%), and Klebsiella pneumoniae (13.9%) being the most frequent pathogens. The predominant pathogens exhibited extensive resistance to β-lactams, cephalosporins, and carbapenems. Susceptibility was largely retained only to colistin, tigecycline, and amikacin. Mechanical ventilation was significantly associated with death or a severe clinical outcome (p = 0.03; Cramer’s V = 0.21).

Conclusion: GNB dominate ICU-acquired infections in Vietnam and demonstrate alarming antimicrobial resistance, under-scoring the urgent need for strengthened infection control and antimicrobial stewardship.