Antimicrobial-resistant Pseudomonas aeruginosa and Acinetobacter baumannii From Patients With Hospital-acquired or Ventilator-associated Pneumonia in Vietnam.
Multidrug-resistant bacterial pathogens are becoming a significant problem worldwide. Acinetobacter baumannii and Pseudomonas aeruginosa are problematic multidrug-resistant pathogens. This multicenter study in Vietnam determined the level of resistance to antimicrobial agents used to treat A baumannii and P aeruginosa infections in this country.



Five medical centers in Vietnam provided 529 P aeruginosa and 971 Acinetobacter species (904 A baumannii) isolates from patients with hospital-acquired or ventilator-associated pneumonia from 2012 to 2014. A central laboratory verified identification of the isolates and performed susceptibility testing using Clinical and Laboratory Standards Institute methods.



Resistance to cephalosporins, β-lactam/β-lactamase inhibitors, carbapenems, and fluoroquinolones was >90% against A baumannii. Aminoglycosides had only slightly better activity, with amikacin resistance >80%. Only colistin (MIC90, ≤0.25 mg/L) and tigecycline (MIC90, 4 mg/L) had appreciable activity against A baumannii. Similar activity was observed among the β-lactams tested against P aeruginosa. Cefepime demonstrated the highest activity (60.1% susceptible), which was similar to doripenem (58.6% susceptible), the most active carbapenem tested. Amikacin was the most active aminoglycoside tested against P aeruginosa, with susceptibility of 81.7% compared with tobramycin (58.0%) and gentamicin (56.5%). Fluoroquinolones had limited activity against P aeruginosa with susceptibility to ciprofloxacin (55.0%). All P aeruginosa isolates had colistin MIC values ≤2 mg/L.



The data from this 3-year longitudinal study in Vietnam demonstrate that 2 of the most common nonfermentative gram-negative pathogens associated with hospital-acquired and ventilator-associated pneumonia are significantly resistant to most of the available treatment options and require combination therapies unless new antimicrobial agents become available.
International Health Management Associates, Inc, Schaumburg, Illinois. Electronic address: rbadal@ihmainc.com.
Douglas J
DJ
Biedenbach
MSD Vietnam, Ho Chi Minh City, Vietnam.
Phan Trong
PT
Giao
Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam.
Pham
P
Hung Van
Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam.
Nguyen
N
Su Minh Tuyet
Cho Ray Hospital, Ho Chi Minh City, Vietnam.
Tran
T
Thi Thanh Nga
Bach Mai Hospital, Hanoi, Vietnam.
Doan Mai
DM
Phuong
National Hospital for Tropical Diseases, Hanoi, Vietnam.
Nguyen
N
Vu Trung
International Health Management Associates, Inc, Schaumburg, Illinois.
Robert E
RE
Badal
D040981:Acinetobacter baumannii / Q000187:drug effects*; D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D000077726:Doripenem; D024901:Drug Resistance, Multiple, Bacterial; D024841:Fluoroquinolones / Q000494:pharmacology; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D008137:Longitudinal Studies; D008826:Microbial Sensitivity Tests / Q000379:methods; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D000078304:Tigecycline; D014744:Vietnam; D065093:beta-Lactamase Inhibitors / Q000494:pharmacology; D047090:beta-Lactams / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D024841:Fluoroquinolones; D005839:Gentamicins; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams; D000078304:Tigecycline; D000077723:Cefepime; D000583:Amikacin; D000077726:Doripenem; D008911:Minocycline
Vietnam; antimicrobial resistance; carbapenems; surveillance