Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May;71 Suppl 1(Suppl 1):i93-102.
doi: 10.1093/jac/dkw069.

Results from the Survey of Antibiotic Resistance (SOAR) 2009-11 in Vietnam

P H Van  1 , P T Binh  1 , N H L Minh  2 , I Morrissey  3 , D Torumkuney  4
Affiliations

Results from the Survey of Antibiotic Resistance (SOAR) 2009-11 in Vietnam

P H Van et al. J Antimicrob Chemother. 2016 May.

Abstract

Objectives: To investigate the susceptibility of respiratory tract infection pathogens collected between 2009 and 2011 from the SOAR study in Vietnam.

Methods: MICs were determined using Etest(®) and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.

Results: Two hundred and eighty-nine Streptococcus pneumoniae and 195 Haemophilus influenzae were collected from 11 centres. Overall, 4.8% of S. pneumoniae were penicillin susceptible (CLSI oral and EUCAST breakpoints). Using CLSI intravenous breakpoints, 86.9% were penicillin susceptible. Susceptibility to high-dose amoxicillin/clavulanic acid (or amoxicillin) using PK/PD breakpoints, cefuroxime (using CLSI or PK/PD breakpoints), cefaclor (CLSI breakpoint) and azithromycin (CLSI breakpoint) was 96.9%, 18.7%, 8% and 4.2%, respectively. Ofloxacin susceptibility was 93.4% by CLSI but 0% by EUCAST. All S. pneumoniae were fully vancomycin susceptible. S. pneumoniae from children were significantly less susceptible to most antimicrobials than those from the elderly. For ofloxacin, however, the reverse was true.Among H. influenzae isolates, 40.5% produced β-lactamase and 13.8% were β-lactamase negative but ampicillin resistant (BLNAR) by CLSI. H. influenzae were highly susceptible (97.4%) in vitro to amoxicillin/clavulanic acid and also to ceftriaxone by CLSI and PK/PD breakpoints but not EUCAST breakpoints. However, BLNAR isolates should be considered clinically resistant, with susceptibility reduced to 84.1%. With EUCAST breakpoints, amoxicillin/clavulanic acid susceptibility was lower, at 63.1%. Azithromycin susceptibility was 79.5% (CLSI).

Conclusions: Resistance to antibacterials in Vietnam was high, with amoxicillin/clavulanic acid being the most active agent. Ceftriaxone was highly active against H. influenzae while ofloxacin appeared highly active against S. pneumoniae using CLSI but not by EUCAST breakpoints. Ongoing surveillance through SOAR will further assist in understanding susceptibility trends over time.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
MIC distribution for (a) amoxicillin/clavulanic acid, azithromycin and penicillin and (b) cefaclor, cefuroxime and ofloxacin against all S. pneumoniae.
Figure 2.
Figure 2.
Percentage susceptible rates for antimicrobials according to CLSI breakpoints against penicillin-susceptible (PSSP), penicillin-intermediate (PISP) and penicillin-resistant S. pneumoniae (PRSP). AMC, amoxicillin/clavulanate; SXT, trimethoprim/sulfamethoxazole. Penicillin susceptibility category was based on oral penicillin CLSI breakpoints.
Figure 3.
Figure 3.
MIC distribution for (a) amoxicillin/clavulanic acid, azithromycin, clarithromycin and ampicillin and (b) cefaclor, cefuroxime and ceftriaxone against all H. influenzae.
Figure 4.
Figure 4.
Percentage susceptible rates for antimicrobials according to CLSI and EUCAST breakpoints against H. influenzae. AMC, amoxicillin/clavulanate.
Figure 5.
Figure 5.
Percentage susceptible rates for antimicrobials against H. influenzae by age group according to CLSI breakpoints. No significant difference was found between the age groups. AMC, amoxicillin/clavulanate.
Figure 6.
Figure 6.
Percentage susceptibility rates for antimicrobials against S. pneumoniae by age group according to CLSI breakpoints. Paediatric susceptibility was significantly lower than in the elderly (but not adults) for amoxicillin/clavulanic acid (P = 0.001), cefaclor (P = 0.001), cefuroxime (P < 0.0001), penicillin iv (P = 0.003) and penicillin oral (P = 0.001). Paediatric susceptibility was significantly lower than in the elderly and adults for azithromycin (P < 0.0001 and 0.013, respectively). Paediatric susceptibility was significantly higher than in the elderly and adults for ofloxacin (P = 0.0003 and <0.0001, respectively).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mandell LA, Wunderink RG, Anzueto A et al. . Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44 Suppl 2: S27–72. - PMC - PubMed
    1. Ramirez JA, Anzueto AR. Changing needs of community-acquired pneumonia. J Antimicrob Chemother 2011; 66 Suppl 3: iii3–9. - PMC - PubMed
    1. Takahashi K, Suzuki M, Minh le N et al. . The incidence and aetiology of hospitalised community-acquired pneumonia among Vietnamese adults: a prospective surveillance in Central Vietnam. BMC Infect Dis 2013; 13: 296–307. - PMC - PubMed
    1. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Disk Susceptibility Tests—Eleventh Edition: Approved Standard M02-A11. CLSI, Wayne, PA, USA, 2012.
    1. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-fourth Informational Supplement M100-S24. CLSI, Wayne, PA, USA, 2014.

MeSH terms

Substances

LinkOut - more resources