THỰC TRẠNG KHÁNG KHÁNG SINH CỦA VI KHUẨN GRAM ÂM GÂY NHIỄM KHUẨN HUYẾT TẠI BỆNH VIỆN UNG BƯỚU NGHỆ AN GIAI ĐOẠN 2020-2024

Abstract

Background: Bloodstream infections, caused primarily by gram-negative bacteria, are a prevalent and serious systemic infection in clinical settings. Regular monitoring of the causative agents and their antibiotic susceptibility is essential to improve treatment effectiveness. Objective: To describe the antibiotic resistance status of Gram-negative bacteria causing bloodstream infections at Nghe An Oncology Hospital during the period 2020-2024.Subjects and Methods: We conducted a cross-sectional descriptive analysis on 187  adult patients who were clinically diagnosed with bloodstream infections  and had positive blood cultures for Gram-negative bacteria during the period from January 2020 to June 2024. Results: The average age of study subjects was 61,8 years, with the majority being male (72,7%). The mean duration of treatment was 18,5 days. Patients had multiple underlying conditions, with cancer (87,7%) and hepatitis/cirrhosis (25,1%) being the most common. The primary pathogens isolated were E. coli (48,1%) and K. pneumoniae (22,5%). 60% of E. coli strains isolated produced ESBL, while the ESBL production rate in K. pneumoniae was 28,6%. The isolated bacteria showed resistance to a majority of the antibiotics tested at varying levels. E. coli exhibited the highest resistance to Amplicillin (93,3%), while it was least resistant to Carbapenem (3,3%). . Similarly, K. pneumonia showed the highest resistance to Amplicillin  (95,2%), but was least resistant to Imipenem (9,5%). There have been no reported cases of Colistin resistance in P. aeruginosa and A. baumannii. ESBL-producing bacteria displayed significantly higher levels of resistance compared to non-ESBL-producing bacteria. Among the bacteria studied, E. coli had the highest rate of multidrug resistance, with 88,9% being classified as MDR, 26,7% as XDR, and 3,3% as PDR. P. aeruginosa, had the highest rate of non-MDR at 76,9%. The highest rate of PDR was found in A. baumannii at 23,1%, followed by Enterobacter spp at 15,4%. Conclusion: The pathogens causing bloodstream infections exhibit high levels of resistance or partial resistance to tested antibiotics. The high prevalence of ESBL-producing bacteria, long with the emergence of XDR and PDR strains, presents a significant clinical challenge in treating patients. This highlights the urgent need for the development of novel antibiotics and the implementation of stricter antibiotic stewardship programs and infection control enhance activities in hospitals.