NGHIÊN CỨU TÌNH HÌNH VÀ ĐẶC ĐIỂM NHIỄM TRÙNG HUYẾT DO MỘT SỐ VI KHUẨN GRAM ÂM KHÁNG CARBAPENEM TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ

Abstract

Background: Carbapenem-resistant gram-negative bacteria (CR-GNB) are highly dangerous pathogens that are difficult to treat and capable of widespread transmission of resistance genes among hospital-acquired bacterial strains. Objective: To determine the prevalence and describe the characteristics of CR-GNB infections in patients with bacteremia. Materials and methods: A cross-sectional descriptive study was conducted on 40 patients with bacteremia treated at Can Tho Central General Hospital. Results: The male/female ratio was 1.0, with the majority (55.0%) being aged 60 years or older. The mean body mass index (BMI) was 22.64 ± 1.49 kg/m². Diabetes mellitus was present in 35.0% of cases. Regarding bacteremia characteristics, the mean Sequential Organ Failure Assessment (SOFA) score was 14.35 ± 1.99. The primary infection sources were predominantly respiratory (57.5%), followed by gastrointestinal (35.0%), and urinary tract (7.5%). Systemic symptoms included fever (42.5%), chills (35.0%), and altered consciousness (7.5%). Other common symptoms were productive cough (55.0%) and dyspnea (42.5%). The mean white blood cell count was 15.8 ± 9.2 G/L. The median procalcitonin level was 15.1 ng/mL, and the mean blood lactate level was 7.1 ± 4.87 mmol/L. The distribution of carbapenem-resistant gram-negative bacteria was as follows: Klebsiella pneumoniae (37.0%), Acinetobacter baumannii (37.0%), Escherichia coli (10.0%), Klebsiella aerogenes (8.0%), Pseudomonas aeruginosa (5.0%), and Proteus mirabilis (3.0%). Conclusion: Carbapenem-resistant gram-negative bacteremia is commonly observed in elderly patients, with the respiratory tract being the most frequent primary infection source. The two most prevalent pathogens were Klebsiella pneumoniae and Acinetobacter baumannii.