title: Antibiotic susceptibility and molecular epidemiology ofAcinetobacter calcoaceticus-baumanniicomplex strains isolated from a referral hospital in northern Vietnam.
abstract: Acinetobacter calcoaceticus-baumanniicomplex is a common cause of hospital-acquired infections (HAIs) globally, remarkable for its high rate of antibiotic resistance, including to carbapenems. There are few data on the resistance ofA. baumanniiin Vietnam, which are essential for developing evidence-based treatment guidelines for HAIs. Antibiotic susceptibility testing was conducted by VITEK®2, and pulsed-field gel electrophoresis (PFGE) was performed on 66 clinicalA. baumanniicomplex isolates recovered during 2009 at the National Hospital of Tropical Diseases (NHTD), a referral hospital in Hanoi, Vietnam. Basic demographic and clinical data were collected and analysed using descriptive statistics. Most isolates came from lower respiratory tract specimens (59; 89.4%) from intensive care unit (ICU) patients [64/65 (98.5%) with available data] who had been admitted to NHTD for ≥2 days [42/46 (91.3%) with available data]. More than 90% of the isolates were resistant to the tested β-lactamase/β-lactamase inhibitors, cephalosporins, carbapenems, fluoroquinolones and trimethoprim/sulfamethoxazole. Moreover, 25.4% (16/63) were resistant to all tested β-lactams, quinolones and aminoglycosides. All isolates remained sensitive to colistin and 58.7% were susceptible to tigecycline. Of the 66 isolates, 49 could be classified into eight PFGE types (A-H). Every PFGE type, except D, had cluster(s) of three or more isolates with a temporal relationship. In conclusion, these data suggest a significant rise inA. baumanniiantibiotic resistance in Vietnam. Clustering within PFGE types supports cross-transmission ofA. baumanniiwithin the ICU at NHTD. Increased research and resources in optimising treatment, infection control and antibiotic stewardship are needed.
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Trang Dinh
authors.initials: TD
authors.lastname: Van
authors.affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam.
authors.forename: Quynh-Dao
authors.initials: QD
authors.lastname: Dinh
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Phu Dinh
authors.initials: PD
authors.lastname: Vu
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Trung Vu
authors.initials: TV
authors.lastname: Nguyen
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Ca Van
authors.initials: CV
authors.lastname: Pham
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Trinh Tuyet
authors.initials: TT
authors.lastname: Dao
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Cam Dac
authors.initials: CD
authors.lastname: Phung
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Ha Thu Thi
authors.initials: HT
authors.lastname: Hoang
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Nga Thi
authors.initials: NT
authors.lastname: Tang
authors.affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam.
authors.forename: Nga Thuy
authors.initials: NT
authors.lastname: Do
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Viet Nam.
authors.forename: Kinh Van
authors.initials: KV
authors.lastname: Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam ; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK.
authors.forename: Heiman
authors.initials: H
authors.lastname: Wertheim
keywords: Acinetobacter baumannii; Antibiotic resistance; Genotype; Hospital-acquired infection; Ventilator-associated pneumonia