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. 2023 Oct 30;5(4):100318.
doi: 10.1016/j.infpip.2023.100318. eCollection 2023 Dec.

Clinical and microbiological evaluation of ventilator-associated pneumonia in an intensive care unit in Vietnam

Kayoko Hayakawa  1   2 , Nguyen Gia Binh  3 , Dao Xuan Co  3 , Pham The Thach  3 , Pham Thi Phuong Thuy  4 , Ngo Quy Chau  5   6 , Mai Lan Huong  7 , Do Van Thanh  8 , Doan Mai Phuong  7 , Tohru Miyoshi-Akiyama  9 , Maki Nagashima  1 , Norio Ohmagari  1   2
Affiliations

Clinical and microbiological evaluation of ventilator-associated pneumonia in an intensive care unit in Vietnam

Kayoko Hayakawa et al. Infect Prev Pract. .

Abstract

Background: The increasing incidence of multidrug-resistant Gram-negative bacteria causing ventilator-associated pneumonia (VAP) is a global concern. A better understanding of the epidemiology of VAP in Southeast Asia is essential to optimise treatments and patient outcomes.

Methods: VAP epidemiology in an intensive care unit in Vietnam was investigated. A prospective cohort study was conducted. Patients who were ventilated for >48 hours, diagnosed with VAP, and had a positive respiratory culture between October 2015 and March 2017 were included. Whole-genome sequencing (WGS) was performed on Acinetobacter baumannii isolates.

Results: We identified 125 patients (137 episodes) with VAP from 1,699 admissions. Twelve patients had 2 VAP episodes. The median age was 60 years (interquartile range: 48-70), and 68.8% of patients were male. Diabetes mellitus was the most frequent comorbidity (N=35, 28%). Acinetobacter baumannii was most frequently isolated in the first VAP episode (N=84, 67.2%) and was multiply resistant to meropenem, levofloxacin, and amikacin. The 30-day mortality rate was 55.2% (N=69) and higher in patients infected with A. baumannii (N=52, 65%). WGS results suggested a complex spread of multiple clones.

Conclusions: In an intensive care unit in Vietnam, VAP due to A. baumannii had a high mortality rate, and A. baumannii and K. pneumoniae were multidrug resistant, with carbapenem resistance of 97% and 70%, respectively.

Keywords: Acinetobacter; Asia; Colistin; Healthcare-associated infection; ICU; Multidrug-resistant.

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Figures

Figure 1
Figure 1
Genetic relatedness of the A. baumannii isolates in this study as determined by whole-genome sequencing (WGS). Thirty-seven strains isolated during the 1st term of the study were subdivided based on MLST, MLST plus drug resistance genes, and common and unique SNPs. The numbers above arrows at the branches under SNPs indicate the numbers of newly emerged SNPs. As for the branches from Ac105 to Ac112 and Ac129, the number of SNPs was too high to count and is therefore indicated as ∗.
See this image and copyright information in PMC

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