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

BMC Infectious Diseases

Trung Vu Nguyen¹  Hoa Thi Nguyen¹  Chi Linh Bui¹  Vu Quoc Dat¹  Hung Nguyen The¹  Hieu Ngoc Vu¹  Kinh Van Nguyen²  Dao Tuyet Trinh²  Long Bao Hoang³  Behzad Nadjm³  Dung Vu Tien Viet³  H. Rogier van Doorn³  Heiman F.L. Wertheim³  Alessandro Torre³ 

[1]Department of Infectious Diseases, Hanoi Medical University

[2]National Hospital for Tropical Diseases

[3]Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit

关键词: bacteremia;    bloodstream infection;    Vietnam;    sepsis;    drug resistance, bacterial;    Gram-negative bacteria;   

DOI  :  10.1186/s12879-017-2582-7

来源: DOAJ

【 摘 要 】

Abstract Background Bloodstream 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. Methods A 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. Results A 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.

【 授权许可】

Unknown