Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects
Background: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) gram-negative bacteria (GNB) presents a serious clinical scenario, and there is disagreement regarding the role of colistin in treatment. This study aimed to characterize the antibiotic resistance of MDR GNB and ev...
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MDPI AG
2022-09-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/10/9/1765 |
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| author | Thu Pham Minh Vo Thien Chi Dinh Hung Viet Phan Thuy Thi My Cao Phuoc Thien Duong Thang Nguyen |
| author_facet | Thu Pham Minh Vo Thien Chi Dinh Hung Viet Phan Thuy Thi My Cao Phuoc Thien Duong Thang Nguyen |
| author_sort | Thu Pham Minh Vo |
| collection | DOAJ |
| description | Background: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) gram-negative bacteria (GNB) presents a serious clinical scenario, and there is disagreement regarding the role of colistin in treatment. This study aimed to characterize the antibiotic resistance of MDR GNB and evaluate the treatment outcomes and side effects of colistin in VAP patients caused by MDR GNB, particularly in Vietnam. Methods: A prospective cohort research was undertaken. We enrolled 136 intubated patients diagnosed with VAP according to the Centers for Disease Control and Prevention (CDC) 2019. Sixty-six individuals with an isolated gram-negative bacterium (<i>Acinetobacter baumannii</i>, <i>Klebsiella pneumoniae</i>, or <i>Pseudomonas aeruginosa</i>) satisfied the European Centre for Disease Prevention and Control (ECDC)’s criteria for multi-antibiotic resistance. Results: GNB resistance was categorized as 10.6% MDR, 63.6% XDR, and 25.8% PDR. GNB were resistant to β-lactams 80–100%, aminoglycosides 50–86.7%, fluoroquinolones 100% and colistin 2.8–20%. The 28-day mortality rate was 54.5%, and acute kidney injury occurred at 12.1%. There was no statistically significant difference in mortality rate between groups receiving regimens with or without colistin (58.3% and 73.3%, respectively; OR = 1.964; 95%CI 0.483–7.989). Neither was there a statistically significant difference in acute renal damage rate between groups receiving regimens with or without colistin (14.3% and 9.7%, respectively; OR = 1.556; 95%CI 0.34–7.121). Conclusions: GNB had a high rate of antibiotic resistance to most antibiotics. The addition of colistin to the medication did not show significant differences in renal toxicity or mortality, while colistin resistance was relatively low; larger studies need to be conducted. |
| first_indexed | 2024-03-09T23:52:38Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T23:52:38Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-6bcc5f4e33d64404a4719d9a846e20df2023-11-23T16:30:32ZengMDPI AGHealthcare2227-90322022-09-01109176510.3390/healthcare10091765Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse EffectsThu Pham Minh Vo0Thien Chi Dinh1Hung Viet Phan2Thuy Thi My Cao3Phuoc Thien Duong4Thang Nguyen5Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, VietnamDepartment of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, VietnamDepartment of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, VietnamDepartment of Respiratory, Can Tho Central General Hospital, Can Tho City 900000, VietnamIntensive Care Unit, Can Tho Central General Hospital, Can Tho City 900000, VietnamDepartment of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, VietnamBackground: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) gram-negative bacteria (GNB) presents a serious clinical scenario, and there is disagreement regarding the role of colistin in treatment. This study aimed to characterize the antibiotic resistance of MDR GNB and evaluate the treatment outcomes and side effects of colistin in VAP patients caused by MDR GNB, particularly in Vietnam. Methods: A prospective cohort research was undertaken. We enrolled 136 intubated patients diagnosed with VAP according to the Centers for Disease Control and Prevention (CDC) 2019. Sixty-six individuals with an isolated gram-negative bacterium (<i>Acinetobacter baumannii</i>, <i>Klebsiella pneumoniae</i>, or <i>Pseudomonas aeruginosa</i>) satisfied the European Centre for Disease Prevention and Control (ECDC)’s criteria for multi-antibiotic resistance. Results: GNB resistance was categorized as 10.6% MDR, 63.6% XDR, and 25.8% PDR. GNB were resistant to β-lactams 80–100%, aminoglycosides 50–86.7%, fluoroquinolones 100% and colistin 2.8–20%. The 28-day mortality rate was 54.5%, and acute kidney injury occurred at 12.1%. There was no statistically significant difference in mortality rate between groups receiving regimens with or without colistin (58.3% and 73.3%, respectively; OR = 1.964; 95%CI 0.483–7.989). Neither was there a statistically significant difference in acute renal damage rate between groups receiving regimens with or without colistin (14.3% and 9.7%, respectively; OR = 1.556; 95%CI 0.34–7.121). Conclusions: GNB had a high rate of antibiotic resistance to most antibiotics. The addition of colistin to the medication did not show significant differences in renal toxicity or mortality, while colistin resistance was relatively low; larger studies need to be conducted.https://www.mdpi.com/2227-9032/10/9/1765pneumoniaventilator-associateddrug resistancemultiplegram-negative bacteriacolistin |
| spellingShingle | Thu Pham Minh Vo Thien Chi Dinh Hung Viet Phan Thuy Thi My Cao Phuoc Thien Duong Thang Nguyen Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects Healthcare pneumonia ventilator-associated drug resistance multiple gram-negative bacteria colistin |
| title | Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects |
| title_full | Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects |
| title_fullStr | Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects |
| title_full_unstemmed | Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects |
| title_short | Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects |
| title_sort | ventilator associated pneumonia caused by multidrug resistant gram negative bacteria in vietnam antibiotic resistance treatment outcomes and colistin associated adverse effects |
| topic | pneumonia ventilator-associated drug resistance multiple gram-negative bacteria colistin |
| url | https://www.mdpi.com/2227-9032/10/9/1765 |
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