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PREVALENCE OF MULTIDRUG RESISTANCE GRAM - NEGATIVE BACTERIA ISOLATED IN BLOOD CULTURES AT BACNINH PROVINCE HOSPITAL IN 2022
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Abstract
Gram-negative bloodstream infections are common and associated with significant mortality. Treatment is complicated by the spread of multidrug-resistant (MDR) strains, which presents a challenge in selecting appropriate antibiotics and limits the choices for effective therapy. Methods: This cross-sectional study aimed to investigate the prevalence and multidrug resistance of gram-negative bacteria in blood cultures at Bac Ninh Province Hospital in 2022. Results: A total of 161 gram-negative bacteria were isolated in blood cultures. The most common gram-negative species were E. coli (42.2%), followed by B. cepacia (21.1%), K. pneumoniae (14.9%), and A. baumannii (8.1%). The non-susceptible rate of E. coli to extended - spectrum cephalosporins, fluoroquinolones, aminoglycosides, and carbapenems was 58.7%, 52.2%, 41.3%, and 6.5%, respectively. The rates for K. pneumoniae were 26.7%, 53.3%, 46.7%, and 20.0%, respectively, and for A. baumannii were 20.0%, 20.0%, 40.0%, and 30.0%, respectively. The Extended-spectrum β-lactamase rate in E. coli was 34.8%, while this rate in K. pneumoniae was 0%. The MDR rate of the three bacteria was 87.0%, 60.0%, and 30.0%, respectively, while the highest rate of extensively drug-resistant (XDR) species was observed in E. coli (23.9%). One pan drug-resistant (PDR) isolate was detected in either K. pneumoniae or P. aeruginosa. B. cepacia was still susceptible to ceftazidime (100%) and trimethoprim-sulfamethoxazole (96.8%). Conclusions: The leading pathogens causing sepsis were E. coli, B. cepacia, K. pneumoniae, and A. baumannii. The antibiotics for Enterobacteriaceae, B. cepacia, and A. baumannii were carbapenems, ceftazidime, and the combination of carbapenems, extended-spectrum cephalosporins, and fluoroquinolones, respectively. The MDR species was high, especially with the appearance of PDR isolates, posing challenges for physicians in sepsis treatment
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Keywords
Nhiễm khuẩn huyết, đa kháng kháng sinh, gram âm, Enterobacteriaceae, A. baumannii.
References
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