Influential Factors in the Treatment of Pseudomonas aeruginosa Infections at a Tertiary Hospital in Vietnam.

Abstract

As an opportunistic pathogen, Pseudomonas aeruginosa is often associated with severe respiratory infections. A study conducted in an ICU of a tertiary hospital in Vietnam, where infection management is relatively good, yielded only 18 clinical isolates of P. aeruginosa over 6 months. Though the number is small, treating P. aeruginosa infections is highly complicated. Out of 18 patients, 15 showed no improvement after treatment, leading to worsening conditions or death, possibly due to various factors. High rates of mechanical ventilation (83.3%) may be a contributing factor, suggesting a certain correlation between ventilation and treatment failure. The antibiotic resistance rate in these isolates is relatively high, with a multidrug-resistant rate of 44.4%, resulting in treatment failures when empirical antibiotics are used without susceptibility testing. All isolates have the ability to form biofilms. Moreover, bacteria in stationary phase or within biofilms exhibited poor responses to meropenem and amikacin (about 10% of bacteria survive after antibiotic exposure). Conversely, ciprofloxacin shows much better efficacy, indicating that fluoroquinolones should be used in combination therapy for P. aeruginosa infection to eliminate persistent cells and biofilm-embedded microorganisms, thus enhancing treatment effectiveness.