TÌNH HÌNH ĐỀ KHÁNG VÀ SỬ DỤNG KHÁNG SINH TRONG ĐIỀU TRỊ NHIỄM KHUẨN DO ESCHERICHIA COLI VÀ KLEBSIELLA PNEUMONIAE TẠI BỆNH VIỆN THỐNG NHẤT

Abstract

Background: Antibiotic resistance of Escherichia coli and Klebsiella pneumoniae is increasingly serious, which can lead to long-term hospitalization and treatment failure in patients with infections. Objectives: To investigate antimicrobial resistance pattern and antibiotic use in the treatment of Escherichia coli and Klebsiella pneumoniae infections at Thong Nhat Hospital. Methods: A cross-sectional study was conducted on 203 patients diagnosed with infections and had at least one positive Escherichia coli and/or Klebsiella pneumoniae isolate at Thong Nhat Hospital from January 2021 to May 2021. Patient medical records were retrospectively collected for data analysis including demographics, results of laboratory tests, antibiotic sensitivity, and antimicrobial therapy. The appropriateness of empirical antimicrobial therapy was assessed based on 2019 Thong Nhat guideline in antibiotic use. Results: Extended-spectrum β-lactamase (ESBL) producing Escherichia coli was approximately threefold higher than Klebsiella pneumoniae (61.3% vs 17.1%, respectively). The highest resistance level was observed to penicillin, cephalosporin, and fluoroquinolone. Non-ESBL producing Klebsiella pneumoniae showed low susceptible to carbapenem (53-54%). Most patients received monotherapy (33,7%) or duo antibiotic therapy (50,8%). Cephalosporin and fluoroquinolone were the most frequently prescribed. The appropriate rate of empirical therapy regarding to guideline was 70.9%. Conclusion: Clinicians should update this hospital antimicrobial guideline based on current local antibiogram to improve adequate antibiotic therapy.