BURDEN OF CARBAPENEM RESISTANT GRAM-NEGATIVE BACTERIAL INFECTIONS IN VIETNAM - A NATIONAL HOSPITAL SURVEY.

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-08-19 DOI:10.1016/j.jhin.2025.03.019

Mattias Larsson, Truong Le Van Ngoc, Nguyen Thi Dung, Do Thi Ngat, Hoang Thi Bich Ngoc, Nong Minh Vuong, Doan Mai Phuong, Truong Thai Phuong, Pham Hong Nhung, Håkan Hanberger, Le Kien Ngai, Nandini Sreenivasan, Annick Lenglet, Anders Dalsgaard, Do Duy Cuong, Linus Olson

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引用次数: 0

Abstract

Introduction: The WHO Bacterial Pathogen Priority List 2024 highlights Carbapenem-Resistant Gram-Negative Bacteria (CRGNB), including Enterobacterales (CRE) and Acinetobacter baumannii (CRAB), followed by Pseudomonas aeruginosa (CRPA), as top priorities due to their virulence, resistance, transmission, and limited treatment options.

Objective: This national hospital survey aimed to assess the burden of CRGNB infections and evaluate microbiological laboratory capacity across Vietnam.

Methods: An online survey was distributed to central hospitals and provincial Departments of Health in Vietnam's 63 provinces, which then forwarded it to district and private hospitals.

Results: A total of 324 hospitals participated: 20 central, 190 provincial, 106 district, and 8 private. Half reported microbiological capacity for bacterial culture and susceptibility testing. Among 57,667 reported Gram-negative isolates, 17,417 (30.2%) were CRGNB, including Klebsiella pneumoniae (CRE 37%), Escherichia coli (CRE 11%), Acinetobacter baumannii (CRAB 64%), and Pseudomonas aeruginosa (CRPA 39%). CRE sepsis treatment included cephalosporins, aminoglycosides, carbapenems, fluoroquinolones, and colistin. CRE infections were associated with higher crude mortality (31.7% vs. 20.2%, p<0.001), longer hospital stays (10.4 vs. 8.9 days, p<0.001), and higher costs (1,025vs.1,025vs.773, p<0.001) compared to carbapenem-susceptible Enterobacterales. Reported infection prevention and control (IPC) interventions included CRE surveillance (41%), isolation (36%), point prevalence surveys (15%), and cohort care (7%). IPC funding sources included general health insurance (40%) and hospital funds (32%).

Conclusion: CRGNB pose a significant burden in terms of morbidity, mortality, and financial impact. Strengthening microbiological infrastructure, improving CRGNB screening, and enhancing IPC measures are urgently needed.

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越南耐碳青霉烯革兰氏阴性细菌感染负担——一项全国医院调查。

世卫组织2024年细菌病原体重点清单强调，碳青霉烯耐药革兰氏阴性菌（CRGNB），包括肠杆菌（CRE）和鲍曼不动态杆菌（CRAB），其次是铜绿假单胞菌（CRPA），由于其毒力、耐药性、传播和有限的治疗选择，被列为首要重点。目的：这项全国医院调查旨在评估CRGNB感染的负担，并评估越南的微生物实验室能力。方法：将在线调查分发给越南63个省的中心医院和省级卫生厅，然后将其转发给区医院和私立医院。结果：共有324家医院参与，其中中央医院20家，省级医院190家，区级医院106家，私立医院8家。一半报告了细菌培养和药敏试验的微生物量。在57,667株革兰氏阴性分离物中，CRGNB为17,417株（30.2%），包括肺炎克雷伯菌（CRE 37%）、大肠杆菌（CRE 11%）、鲍曼不动杆菌（CRAB 64%）和铜绿假单胞菌（CRPA 39%）。CRE败血症治疗包括头孢菌素、氨基糖苷类、碳青霉烯类、氟喹诺酮类和粘菌素。CRE感染与较高的粗死亡率相关（31.7% vs. 20.2%）。结论：CRGNB在发病率、死亡率和经济影响方面造成了重大负担。加强微生物基础设施建设，改进CRGNB筛选，加强IPC防控措施是当务之急。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.