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. 2017 Jul 12;17(1):493.
doi: 10.1186/s12879-017-2582-7.

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

Vu Quoc Dat  1   2   3 , Hieu Ngoc Vu  4 , Hung Nguyen The  4 , Hoa Thi Nguyen  4 , Long Bao Hoang  5 , Dung Vu Tien Viet  5 , Chi Linh Bui  4 , Kinh Van Nguyen  6 , Trung Vu Nguyen  4   6 , Dao Tuyet Trinh  6 , Alessandro Torre  5 , H Rogier van Doorn  5   7 , Behzad Nadjm  5   7 , Heiman F L Wertheim  5   7   8
Affiliations

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

Vu Quoc Dat et al. BMC Infect Dis. .

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.

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

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was granted from the Ethics committee and review board of the National Hospital for Tropical Diseases, Hanoi, Vietnam (Approval No: 69/HDDD-NDTU). The NHTD ethics committee also approved the waiver of informed consent to participate in this study due to its retrospective design. All patient data were anonymised prior to the analysis.

Consent for publication

Not applicable.

Competing interests

HRvD is a member of the editorial board (Associate Editor) of the BMC Infectious Diseases. The authors otherwise declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of BSI episodes and classification of BSI by location of acquisition. Classification based on the first isolate during hospitalization. HABSI: Hospital-acquired bloodstream infection; CABSI: Community-acquired bloodstream infection. a Contaminant episodes included 22 episodes of B. cepacia, 25 episodes of Alcaligenes spp., 7 episodes of viridans group streptococci, 8 episodes of Ralstonia picketii, 6 episodes of Pseudomonas species (P. fluorescens, P. putida and P. stutzeri) 4 episodes of Chryseobacterium spp., 3 episodes of S. maltophilia, 3 episodes of Serratia marcescens, 3 episodes of Ochrobactrum antrhopi, 2 episodes of Sphingomonas paucimobilis, 1 episode of each E. coli, K. pneumonia, Corynebacterium spp. and Chryseomonas luteola
Fig. 2
Fig. 2
Case-fatality by etiology of bloodstream infection (BSI). Error bars represent the 95% confidence interval (CI) for case mortality proportions
See this image and copyright information in PMC

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