Etiology and antimicrobial resistance of bacterial pathogens causing bloodstream infections at the National Hospital for Tropical Diseases, 2022 - 2024
Main Article Content
Abstract
This descriptive study of 422 patients with culture-confirmed bloodstream infection at the National Hospital for Tropical Diseases (2022 - 2024) compared bacterial aetiology and antimicrobial resistance between community-acquired infection (CAI, n = 287) and hospital-acquired infection (HAI, n = 135). Among 425 isolates, Gram-negative bacteria accounted for 59.8% and were more frequent in HAI (67.9% versus 55.9%; p = 0.020). The three leading pathogens were E. coli (22.8%), S. aureus (18.4%) and K. pneumoniae (14.8%), with a similar distribution across groups. In contrast, S. suis and B. pseudomallei occurred exclusively in CAI, whereas A. baumannii and P. aeruginosa clustered in HAI. Third-generation cephalosporin resistance in E. coli (62.9%) and MRSA (74.4%) were high and did not differ between community-acquired and hospital-acquired infection, whereas K. pneumoniae showed markedly higher third-generation cephalosporin resistance and multidrug resistance in HAI (61.9% versus 7.5% and 57.1% versus 14.3%; p < 0.001). Overall mortality was 20.6% and was higher in HAI (32.6% versus 15.0%; p < 0.001).
Article Details
Keywords
Bloodstream infection, antimicrobial resistance, hospital-acquired infection, Escherichia coli, Klebsiella pneumoniae, MRSA
References
2. Mun SJ, Kim S-H, Kim H-T, Moon C, Wi YM. The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections. BMC infectious diseases. 2022;22(1):336.
3. Friedman ND, Kaye KS, Stout JE, et al. Health care–associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Annals of internal medicine. 2002;137(10):791-797.
4. Nguyen VA, Le HH, Le HHL, et al. Distribution and antibiotic resistance characteristics of bacteria isolated from blood culture in a teaching hospital in Vietnam during 2014–2021. Infection and Drug Resistance. 2023;1677-1692.
5. Vu QD, Vu NH, Nguyen TH, et al. Bacterial bloodstream infections in a tertiary infectious diseases hospital in Northern Vietnam: aetiology, drug resistance, and treatment outcome. BMC infectious diseases. 2017;17(1):493.
6. Nguyen HTT, Chau V, Nguyen PHL, et al. Changing epidemiology and antimicrobial susceptibility of bloodstream infections at a Vietnamese infectious diseases hospital (2010–2020). npj Antimicrobials and Resistance. 2024;2(1):32.
7. Mo Y, Ding Y, Cao Y, et al. ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance. Wellcome open research. 2023;8:179.
8. Slack R.C.B. 69-Hospital infection. Medical microbiology. 2012:718-726.
9. European Centre for Disease Prevention and Control. Surveillance of healthcare-associated infections and prevention indicators in European intensive care units. 2017.
10. Horan T.C, Andrus M, Dudeck M.A. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. American journal of infection control. 2008;36(5):309-332.
11. Magiorakos A-P, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection. 2012;18(3):268-281.
12. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of chronic diseases. 1987;40(5):373-383.
13. Phạm Hồng Nhung, Mai Thị Lan Hương. Mức độ nhạy cảm kháng sinh của một số loài vi khuẩn gây nhiễm trùng huyết thường gặp phân lập tại Bệnh viện Bạch Mai năm 2023. Tạp chí Nghiên cứu Y học. 2024;178(5):70-81.
14. Phan Văn Hậu, Vũ Huy Lượng, Nguyễn Thị Hà Vinh, et al. Tình hình kháng kháng sinh của một số vi khuẩn gây nhiễm khuẩn huyết tại Bệnh viện E năm 2023. Tạp chí Nghiên cứu y học. 2024;175(2):118-128.
15. Wiersinga WJ, Virk HS, Torres AG, et al. Melioidosis. Nature reviews Disease primers. 2018;4(1):17107.
16. Hopkins J, Lee SJ, Waithira N, et al. Prospective characterisation of drug-resistant bloodstream infections in Africa and Asia (ACORN2): a surveillance network assessment. The Lancet Microbe. 2026;7(1).