Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Vo, Thu Pham Minh, Dinh, Thien Chi, Phan, Hung Viet, Cao, Thuy Thi My, Duong, Phuoc Thien, Nguyen, Thang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498604/
https://www.ncbi.nlm.nih.gov/pubmed/36141377
http://dx.doi.org/10.3390/healthcare10091765
_version_ 1784794801487478784
author Vo, Thu Pham Minh
Dinh, Thien Chi
Phan, Hung Viet
Cao, Thuy Thi My
Duong, Phuoc Thien
Nguyen, Thang
author_facet Vo, Thu Pham Minh
Dinh, Thien Chi
Phan, Hung Viet
Cao, Thuy Thi My
Duong, Phuoc Thien
Nguyen, Thang
author_sort Vo, Thu Pham Minh
collection PubMed
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 (Acinetobacter baumannii, Klebsiella pneumoniae, or Pseudomonas aeruginosa) 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.
format Online
Article
Text
id pubmed-9498604
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94986042022-09-23 Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects Vo, Thu Pham Minh Dinh, Thien Chi Phan, Hung Viet Cao, Thuy Thi My Duong, Phuoc Thien Nguyen, Thang Healthcare (Basel) Article 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 (Acinetobacter baumannii, Klebsiella pneumoniae, or Pseudomonas aeruginosa) 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. MDPI 2022-09-14 /pmc/articles/PMC9498604/ /pubmed/36141377 http://dx.doi.org/10.3390/healthcare10091765 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vo, Thu Pham Minh
Dinh, Thien Chi
Phan, Hung Viet
Cao, Thuy Thi My
Duong, Phuoc Thien
Nguyen, Thang
Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Vietnam: Antibiotic Resistance, Treatment Outcomes, and Colistin-Associated Adverse Effects
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498604/
https://www.ncbi.nlm.nih.gov/pubmed/36141377
http://dx.doi.org/10.3390/healthcare10091765
work_keys_str_mv AT vothuphamminh ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects
AT dinhthienchi ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects
AT phanhungviet ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects
AT caothuythimy ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects
AT duongphuocthien ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects
AT nguyenthang ventilatorassociatedpneumoniacausedbymultidrugresistantgramnegativebacteriainvietnamantibioticresistancetreatmentoutcomesandcolistinassociatedadverseeffects