Antibiotic resistance among ICU patients during the COVID-19 pandemic and its associated factors: a retrospective study using electronic medical records in two Vietnamese hospitals.

Abstract

Antimicrobial resistance (AMR) in intensive care units (ICUs) is a critical issue, which has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. This study investigated AMR prevalence and its associated factors among ICU patients in two Vietnamese hospitals from January 2020 to June 2022. Electronic medical records of 1,296 patients with 2,432 non-duplicate bacterial isolates were collected in Phu Tho Hospital (Northern, rural, non-COVID-19 treatment) and 175 Hospital (Southern, urban, COVID-19 treatment centre). Antibiotic susceptibility testing was conducted using VITEK2, BD Phoenix 100, and disk diffusion methods. Logistic regression with 1,000 bootstrap resampling and cross-validation was used to examine factors linked to AMR. Results revealed Acinetobacter spp. (27.5%) as leading strains in Phu Tho Hospital, while Klebsiella spp. (28.0%) predominated in 175 Hospital, except during 2021when Acinetobacter spp. reached the peak. Alarmingly, Acinetobacter spp., Klebsiella spp., and Pseudomonas aeruginosa demonstrated the highest AMR rates and multidrug resistance rates (83.8%-95.8%) in both hospitals. Resistance to cephalosporins, carbapenems, and fluoroquinolones ranged from 75% to 100%. Significant associated factors included age, sex, location, initial admission diagnosis, and bacterial isolation month. This study highlights the urgent need for controlling AMR in ICUs during the pandemic.