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Войти в исследования The Journal of hospital infection · 2025
Burden of carbapenem-resistant Gram-negative bacterial infections in Vietnam: a national hospital survey.
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Larsson M, Truong L V N, Nguyen T D, Do T N, Hoang T B N, Nong M V, Doan M P, Truong T P, Pham H N, Hanberger H, Le K N, Sreenivasan N, Lenglet A, Dalsgaard A, Do D C, Olson L
Аннотация
INTRODUCTION: The World Health Organization Bacterial Pathogen Priority List 2024 highlights carbapenem-resistant Gram-negative bacteria (CRGNB), including Enterobacterales (CRE), Acinetobacter baumannii (CRAB) and 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 the 63 provinces of Vietnam, which then forwarded it to district and private hospitals.
RESULTS: In total, 324 hospitals participated in this study: 20 central hospitals, 190 provincial hospitals, 106 district hospitals and eight private hospitals. 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%), A. baumannii (CRAB 64%) and P. aeruginosa (CRPA 39%). CRE sepsis treatment included cephalosporins, aminoglycosides, carbapenems, fluoroquinolones and colistin. CRE infections were associated with higher crude mortality rates (31.7% vs 20.2%; P<0.001), longer hospital stays (10.4 vs 8.9 days; P<0.001), and higher costs (1025 vs 773; P<0.001) compared with 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. There is an urgent need to strengthen the microbiological infrastructure, improve CRGNB screening, and enhance IPC measures.
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 the 63 provinces of Vietnam, which then forwarded it to district and private hospitals.
RESULTS: In total, 324 hospitals participated in this study: 20 central hospitals, 190 provincial hospitals, 106 district hospitals and eight private hospitals. 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%), A. baumannii (CRAB 64%) and P. aeruginosa (CRPA 39%). CRE sepsis treatment included cephalosporins, aminoglycosides, carbapenems, fluoroquinolones and colistin. CRE infections were associated with higher crude mortality rates (31.7% vs 20.2%; P<0.001), longer hospital stays (10.4 vs 8.9 days; P<0.001), and higher costs (1025 vs 773; P<0.001) compared with 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. There is an urgent need to strengthen the microbiological infrastructure, improve CRGNB screening, and enhance IPC measures.