Prevalence of multiresistant Gram-negative organisms in a surgical hospital in Ho Chi Minh City, Vietnam.
OBJECTIVE
To determine resistance patterns of multiresistant Gram-negative organisms at a surgical hospital in Ho Chi Minh City, Vietnam, in order to guide appropriate antibiotic prescribing and improve infection control procedures.


METHODS
All samples sent in for microbiological analysis over a 3-month period were included. A resource neutral double disc-diffusion test was introduced to detect the presence of extended-spectrum beta-lactamase (ESBL) production.


RESULTS
We obtained 350 bacterial isolates from clinical specimens; 87.4% were Gram-negative bacteria (GNB). Of these, 88.9% were Enterobacteriaceae, of which 14.7% produced ESBL. Fifteen (37.5%) of these were isolated within 48 h of admission. Resistance to gentamicin and ciprofloxacin occurred in 70.0% and 72.5% of those organisms that produced ESBL and in 39.5% and 38.7% of those that did not. Resistance to third-generation cephalosporins was common: 36.7% of all GNB were resistant to ceftriaxone, 34.0% to cefotaxime, 19.6% to ceftazidime and 36.7% to cefoperazone.


CONCLUSIONS
Multiresistant Gram-negative organisms are common and pose a challenge to antibiotic therapy. Successful implementation of a simple test to detect ESBL production allowed reporting of these organisms, appropriate antibiotic prescribing and infection control interventions. Development of antibiotic-prescribing guidelines must take into account these resistance patterns.
Jones
S L
SL
Department of Infectious Diseases, Barwon Health, Geelong, Australia.
Nguyen
V K
VK
Nguyen
T M P
TM
Athan
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018550:Cephalosporin Resistance; D002939:Ciprofloxacin / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000201:enzymology / Q000517:prevention & control; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014744:Vietnam; D001618:beta-Lactamases / Q000378:metabolism
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D001618:beta-Lactamases