Antimicrobial susceptibility testing and antibiotic consumption results from 16 hospitals in Viet Nam: The VINARES project 2012–2013. (September 2019)

• Record Type: Journal Article
• Authors: Vu, Tien Viet Dung; Do, Thi Thuy Nga; Rydell, Ulf; Nilsson, Lennart E.; Olson, Linus; Larsson, Mattias; Hanberger, Håkan; Choisy, Marc; Dao, Tuyet Trinh; van Doorn, H. Rogier; Nguyen, Van Kinh; Nguyen, Vu Trung; Wertheim, Heiman F.L.
• Is Part Of: Journal of global antimicrobial resistance. Volume 18(2019)
• Page Start: 269
• Page End: 278
• Publication Date: 2019-09
• Subjects: Antimicrobial resistance -- Surveillance -- Defined daily dose (DDD)/1000 patient-days -- Hospital-based surveillance -- Viet Nam; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2019.06.002
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: Antibiotic use and antimicrobial resistance varied greatly by hospitals in VINARES. 70% of antibiotic use were cephalosporins, fluoroquinolones and penicillin. Vancomycin resistance rates were low in Gram-positive bacteria. Carbapenem resistance was around 20% in Enterobacteriaceae. Resistance to carbapenem was 30% in Pseudomonas aeruginosa but 70% in Acinetobacter spp. Abstract: Objective: To establish a hospital-based surveillance network with national coverage for antimicrobial resistance (AMR) and antibiotic consumption in Viet Nam. Methods: A 16-hospital network (Viet Nam Resistance: VINARES) was established and consisted of national and provincial-level hospitals across the country. Antimicrobial susceptibility testing results from routine clinical diagnostic specimens and antibiotic consumption data in Defined Daily Dose per 1000 bed days (DDD/1000 patient-days) were prospectively collected and analysed between October 2012 and September 2013. Results: Data from a total of 24 732 de-duplicated clinical isolates were reported. The most common bacteria were: Escherichia coli (4437 isolates, 18%), Klebsiella spp. (3290 isolates, 13%) and Acinetobacter spp. (2895 isolates, 12%). The hospital average antibiotic consumption was 918 DDD/1000 patient-days. Third-generation cephalosporins were the most frequently used antibiotic class (223 DDD/1000 patient-days, 24%), followed by fluoroquinolones (151 DDD/1000 patient-days, 16%) and second-generation cephalosporins (112 DDD/1000 patient-days, 12%). Proportions of antibiotic resistance were high: 1098/1580 (69%) Staphylococcus aureus isolates were methicillin-resistant (MRSA); 115/344 isolates (33%) and 90/358 (25%) Streptococcus pneumoniae had reduced susceptibility to penicillin and ceftriaxone, respectively. A total of 180/2977 (6%) E. coli and 242/1526 (16%) Klebsiella pneumoniae were resistant to imipenem, respectively; 602/1826 (33%) Pseudomonas aeruginosa were resistant to ceftazidime and 578/1765 (33%) to imipenem. Of Acinetobacter spp. 1495/2138 (70%) were resistant to carbapenems and 2/333 (1%) to colistin. Conclusions: These data are valuable in providing a baseline for AMR among common bacterial pathogens in Vietnamese hospitals and to assess the impact of interventions.