DOI: 10.29090/psa.2020.04.019.0118 | Pharm Sci Asia 2020; 47(4), 387-398 |
Hospital-acquired pneumonia in an intensive care unit in Vietnam: clinical characteristics and pathogenic bacteriaThao T.B. Nguyen1,
Kien T. Nguyen2,
Suol T. Pham3*,
Xuan D. Pham4,
Thang Nguyen3
1 Department of Intensive Care, Can Tho General
Hospital, Can Tho, Vietnam 2
Department of Physiology, Can Tho University
of Medicine and Pharmacy, Can Tho, Vietnam 3
Department of Pharmacology and Clinical
Pharmacy, Can Tho University of Medicine
and Pharmacy, Can Tho, Vietnam 4
Faculty of Pharmacy, Can Tho University of
Medicine and Pharmacy, Can Tho, Vietnam
The increase in the number of multi-drug resistant bacteria causing nosocomial infections at the hospital’s intensive care unit (ICU) is a major worldwide problem. This leads to the need for research on clinical characteristics and pathogenic bacteria of hospital-acquired pneumonia (HAP) patients. Our research aimed to describe the clinical characteristics and identify the patterns of causative agents in HAP patients. We conducted a cross-sectional descriptive study on 103 HAP patients treated in ICU of a major hospital in Can Tho City, Vietnam from May 2017 to May 2018. The identification and antimicrobial susceptibility of cultures were determined using an automated microbiology analyzer; the Bauer–Kirby disk diffusion method was used. Of 103 patients met the inclusion criteria, 95 patients were confirmed as presenting with HAP caused by MDR bacteria. The overall prevalence was higher in men than in women and increased with age. There was some evidence of a correlation between prior broad-spectrum antibiotic use and the incidence of HAP. The sputum color change and hyperthermia were common clinical symptoms in HAP diagnosing. Notably, the proportion of multiple-antibiotic-resistant bacteria causing HAP was 92.5%. High rates of most common antibiotic resistance were observed in Acinetobacter baumannii, Klebsiella, Pseudomonas aeruginosa and also E. coli. The success rate of treatment for HAP caused by MDR bacteria accounted for 49.5%. The resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to most common antibiotics were increasing substantially. The initial treatment for HAP ought to comply with combined antibiotic therapy or a new treatment strategy.
Keyword:
Hospital-acquired pneumonia (HAP); Ventilator-associated pneumonia (VAP); Intensive Care Unit (ICU); Clinical characteristics; Pathogenic bacteria
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