Morbidity patterns, mortality, and antimicrobial resistance among children hospitalized in neonatal and pediatric intensive care units in a rural area of Vietnam.

OBJECTIVES

To describe disease burden and antibiotic resistance among children hospitalized in the neonatal department (ND) and pediatric intensive care unit (PICU) in a rural area of Vietnam.

METHODS

This was a retrospective study. Data on admissions to the ND and PICU from 2022 to 2024 were extracted and analyzed from electronic medical records.

RESULTS

2359 patients were included. Respiratory tract infections accounted for 44.6% of all diagnoses, followed by respiratory failure or asphyxia (24.3%), neonatal jaundice (11.5%), and sepsis (9.9%). Cardiovascular, digestive, neurological diseases, COVID-19, and anemia each contributed 0.5-2.4%. Length of stay was shorter for non-infectious diseases compared with infectious diseases (median 6 vs 10 days, P < 0.001). The overall proportion of worst outcomes (death or severe illness with discharge at family request) was 3.4%. Respiratory failure or asphyxia accounted for 70.0% of these cases, followed by prematurity (26.2%) and respiratory tract infections (16.2%). Among 174 bacterial isolates, 61.5% were multidrug-resistant, 6.9% extensively drug-resistant, and 1.1% pandrug-resistant with 44.2% of extended-spectrum beta-lactamase Enterobacteriaceae and 19.2% of carbapenemase-producing Enterobacteriaceae. A total of 36 of 41 (87.8%) Staphylococcus aureus isolates were methicillin-resistant.

CONCLUSION

Improving survival in resource-limited settings requires better perinatal and respiratory care, stronger infection prevention, timely diagnostics, and antibiotic stewardship.