Antimicrobial Resistance Patterns of Common Gram-Negative Microorganisms Isolated from Patients with Lower Respiratory Tract Infections in a Teaching Hospital in Vietnam

Jpn J Infect Dis. 2024 May 23;77(3):144-154. doi: 10.7883/yoken.JJID.2023.260. Epub 2024 Jan 31.

Abstract

This cross-sectional study investigated the antimicrobial resistance (AMR) patterns of gram-negative pathogens isolated from 4,789 hospitalized patients with lower respiratory tract infections (LRTIs). Of the collected specimens, 1,325 (27.7%) tested positive for gram-negative bacteria. Acinetobacter baumannii (38.6%), Pseudomonas aeruginosa (33.5%), Klebsiella pneumoniae (18.7%), Escherichia coli (5.6%), and Klebsiella aerogenes (3.5%) were the most prevalent isolates. AMR analysis revealed high resistance rates (79.9%-100%) of A. baumannii isolates to multiple classes of antibiotics except amikacin, trimethoprim/sulfamethoxazole, and colistin. P. aeruginosa displayed low resistance to colistin (< 10%) but high resistance to other antibiotics. K. pneumoniae displayed high resistance rates of 90.0%-100.0% to most penicillins, whereas resistance rates were notably lower for colistin (7.1%) and amikacin (16.7%). K. aerogenes exhibited high resistance to various antibiotics and sensitivity to amikacin (95.1%), ampicillin (100.0%), and colistin (100.0%). E. coli isolates exhibited resistance to ampicillin (96.9%) and maximum sensitivity to several antibiotics. Our study identified significant AMR trends and highlighted the prevalence of multidrug-resistant strains (93.6% for K. aerogenes and 69.1%-92.4% for other isolates). These findings emphasize the urgent need for appropriate antibiotic management practices to combat AMR in gram-negative pathogens associated with LRTIs.

Keywords: Vietnam; antimicrobial resistance; hospital; lower respiratory tract infections.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents* / pharmacology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial*
  • Female
  • Gram-Negative Bacteria* / drug effects
  • Gram-Negative Bacteria* / isolation & purification
  • Gram-Negative Bacterial Infections* / epidemiology
  • Gram-Negative Bacterial Infections* / microbiology
  • Hospitals, Teaching*
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Respiratory Tract Infections* / epidemiology
  • Respiratory Tract Infections* / microbiology
  • Vietnam / epidemiology
  • Young Adult

Substances

  • Anti-Bacterial Agents