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

BMC Infectious Diseases

Research Article

Hieu Ngoc Vu¹  Chi Linh Bui¹  Hung Nguyen The¹  Hoa Thi Nguyen¹  Trung Vu Nguyen²  Vu Quoc Dat³  Kinh Van Nguyen⁴  Dao Tuyet Trinh⁴  Alessandro Torre⁵  Dung Vu Tien Viet⁵  Long Bao Hoang⁵  H. Rogier van Doorn⁶  Behzad Nadjm⁶  Heiman F.L. Wertheim⁷ 

[1] Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam;Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam;National Hospital for Tropical Diseases, Hanoi, Vietnam;Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam;National Hospital for Tropical Diseases, Hanoi, Vietnam;Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam;National Hospital for Tropical Diseases, Hanoi, Vietnam;Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam;Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam;Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK;Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam;Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK;Department of Medical Microbiology, Radboudumc, Nijmegen, Netherlands;

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

DOI  :  10.1186/s12879-017-2582-7

 received in 2017-03-15, accepted in 2017-06-30,  发布年份 2017

来源: Springer

【 摘 要 】

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.ConclusionsEnterobacteriaceae (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】

CC BY   
© The Author(s). 2017