NỒNG ĐỘ ỨC CHẾ TỐI THIỂU CỦA KHÁNG SINH VÀ TÌNH TRẠNG ĐỀ KHÁNG KHÁNG SINH CỦA CÁC VI KHUẨN THƯỜNG GẶP TRONG VIÊM PHỔI BỆNH VIỆN VÀ VIÊM PHỔI THỞ MÁY TẠI KHOA HÔ HẤP BỆNH VIỆN CHỢ RẪY

Abstract

Background: Updating antibiotic resistance status and determining the minimum inhibitory concentration (MIC) in hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are essential to improving treatment effectiveness. Objective: To investigate the minimum inhibitory concentration (MIC) and antibiotic resistance status of bacteria causing HAP and VAP. Materials & Method: A cross-sectional descriptive study on patients diagnosed with HAP and VAP treated at the Respiratory Department, Cho Ray Hospital. Results: 82 agents were isolated from 64 patients out of 258 included cases with 53.7% HAP, 46.3% VAP and Gram-negative was the predominant agent with the ratio of A. baumannii, K. pneumoniae , P. aeruginosa, E. coli are 57.3%, 28%, 7.3% and 4.9% respectively. The antibiotics recommended by ATS/IDSA for empirical treatment of Gr(-) bacteria all have MICs that exceed the resistance threshold with high frequency. MIC ^Meropenem ≥ 16 for A. baumannii and P. aeruginosa is 100%, for K. pneumoniae is 78.3%. MIC ^Imipenem ≥ 16 for A. baumannii, P. aeruginosa and K. pneumoniae was similar to Meropenem at 100%, 100% and 69.6%. In contrast, with MRSA, empirical antibiotics all have MICs below the resistance threshold. Conclusion: Bacteria causing HAP - VAP all have MICs exceeding the resistance threshold with high frequency for antibiotics commonly used in clinical practice, and/or recommended for treatment. Multiresistant gram-negative bacteria are mostly resistant to group 2 Carbapenem antibiotics. S. aureus remains susceptible and has low MICs to currently available and recommended antibiotics. The more drug-resistant bacteria a patient has, the higher the MIC, the worse the clinical outcome, especially the higher the mortality rate.