1. Antimicrobial-resistant Pseudomonas aeruginosa and Acinetobacter baumannii From Patients With Hospital-acquired or Ventilator-associated Pneumonia in Vietnam.
- Author
-
Biedenbach DJ, Giao PT, Hung Van P, Su Minh Tuyet N, Thi Thanh Nga T, Phuong DM, Vu Trung N, and Badal RE
- Subjects
- Amikacin pharmacology, Anti-Bacterial Agents pharmacology, Carbapenems pharmacology, Cefepime, Cephalosporins pharmacology, Cross Infection microbiology, Doripenem, Fluoroquinolones pharmacology, Gentamicins pharmacology, Humans, Longitudinal Studies, Microbial Sensitivity Tests methods, Minocycline analogs & derivatives, Minocycline pharmacology, Pneumonia, Bacterial microbiology, Pneumonia, Ventilator-Associated drug therapy, Pneumonia, Ventilator-Associated microbiology, Tigecycline, Vietnam, beta-Lactamase Inhibitors pharmacology, beta-Lactams pharmacology, Acinetobacter baumannii drug effects, Cross Infection drug therapy, Drug Resistance, Multiple, Bacterial, Pneumonia, Bacterial drug therapy, Pseudomonas aeruginosa drug effects
- Abstract
Purpose: Multidrug-resistant bacterial pathogens are becoming a significant problem worldwide. Acinetobacter baumannii and Pseudomonas aeruginosa are problematic multidrug-resistant pathogens. This multicenter study in Vietnam determined the level of resistance to antimicrobial agents used to treat A baumannii and P aeruginosa infections in this country., Methods: Five medical centers in Vietnam provided 529 P aeruginosa and 971 Acinetobacter species (904 A baumannii) isolates from patients with hospital-acquired or ventilator-associated pneumonia from 2012 to 2014. A central laboratory verified identification of the isolates and performed susceptibility testing using Clinical and Laboratory Standards Institute methods., Findings: Resistance to cephalosporins, β-lactam/β-lactamase inhibitors, carbapenems, and fluoroquinolones was >90% against A baumannii. Aminoglycosides had only slightly better activity, with amikacin resistance >80%. Only colistin (MIC90, ≤0.25 mg/L) and tigecycline (MIC90, 4 mg/L) had appreciable activity against A baumannii. Similar activity was observed among the β-lactams tested against P aeruginosa. Cefepime demonstrated the highest activity (60.1% susceptible), which was similar to doripenem (58.6% susceptible), the most active carbapenem tested. Amikacin was the most active aminoglycoside tested against P aeruginosa, with susceptibility of 81.7% compared with tobramycin (58.0%) and gentamicin (56.5%). Fluoroquinolones had limited activity against P aeruginosa with susceptibility to ciprofloxacin (55.0%). All P aeruginosa isolates had colistin MIC values ≤2 mg/L., Implications: The data from this 3-year longitudinal study in Vietnam demonstrate that 2 of the most common nonfermentative gram-negative pathogens associated with hospital-acquired and ventilator-associated pneumonia are significantly resistant to most of the available treatment options and require combination therapies unless new antimicrobial agents become available., (Copyright © 2016. Published by Elsevier Inc.)
- Published
- 2016
- Full Text
- View/download PDF